Physiotherapy

Blonde said:

Hello all,

I have booked myself into a sports physio session next week, as I have
been having knee pain for about four weeks and my GP was useless. The
first session is one hour, any subsequent sessions will be half an
hour. I don't know if this is an injury or an underlying condition and
I don't even know if it's cycling related or not, although it does seme
to be brought on by cold wet weather, regardless of mileage.

I've never had any treatment like this before, so what should I expect?
What qualifications/experience should they have? What do I need to tell
them? What should I ask them? How likely is it they can actually help
me?

I had physio a couple of years ago having lived with a stiff and painful
shoulder for a year or so. At the end of four weeks I had full mobility
back and no pain which has persisted. Having been initially sceptical
that it would do anything I was impressed at the results and their
ability to just look at me standing there and immediately see what the
problem was.

--
Tony

"Anyone who conducts an argument by appealing to authority is not using
his intelligence; he is just using his memory."
- Leonardo da Vinci

Blonde said:

I've never had any treatment like this before, so what should I expect?

Treatment will depend on diagnosis, so can't call that.

Quoted message said:

What qualifications/experience should they have?

Physio is a "profession allied to medicine" and there's a chartering
organisation, the CSP. See http://www.csp.org.uk/

In order to join I imagine you need more than sending them a fiver every
year, so CSP membership would be a start and a degree of guarantee that
they have a Clue, I'd guess.

Quoted message said:

What do I need to tell
them? What should I ask them? How likely is it they can actually help
me?

Tell them as much as you can, ask them anything you feel may be
relevant. As for the third, I'm not a doctor/physio and haven't looked
at your problem, so tough call. But there's a fair chance you'll be in
the hands of someone that can either do you good, or suggest someone
else who might.

Pete.
--
Peter Clinch Medical Physics IT Officer
Tel 44 1382 660111 ext. 33637 Univ. of Dundee, Ninewells Hospital
Fax 44 1382 640177 Dundee DD1 9SY Scotland UK
net [email hidden] http://www.dundee.ac.uk/~pjclinch/

Thanks for link. The one I'm going to is registered with the CSP (I
used the search facility on that website and found them) so that's a
good start.

Blonde said:

Thanks for link. The one I'm going to is registered with the CSP (I
used the search facility on that website and found them) so that's a
good start.

One thing to find out in the first session is whether (s)he is a "treater"
or a "preventer". Some physios, and especially the more sports oriented
ones, are very good at finding out what muscle imbalance or posture caused
your problem, while others focus more on treating where it hurts. If your
pain is caused by something you do regularly, rather than a single
accident, the former may be more useful.

Roos

Thanks. It is a sports physio (female) based at a Virgin Active gym.

Blonde said:

Hello all,

I have booked myself into a sports physio session next week, as I have
been having knee pain for about four weeks and my GP was useless. The
first session is one hour, any subsequent sessions will be half an
hour. I don't know if this is an injury or an underlying condition and
I don't even know if it's cycling related or not, although it does seme
to be brought on by cold wet weather, regardless of mileage.

I have twisted bones in my legs - my feet point outwards more than
they should (and asymmetrically) and the knee joints (especially the
right) are prone to various problems.

I have been through repeated sets of physio, and now know that if I
have problems all I really need from the GP is a referral to a physio
- I've never had a knee problem solved by a GP.

Quoted message said:

I've never had any treatment like this before, so what should I expect?
What qualifications/experience should they have? What do I need to tell
them? What should I ask them? How likely is it they can actually help
me?

Wear clean and presentable underwear. You think you're going to have
some innocuous prodding of an outer extremity and they decide they
want you to strip to your underwear and walk around the room while
they peer closely. That, or they decide the problem needs some
massage or manipulation that requires similar stripping off. I think
the only time I haven't had to take my trousers off at the physio is
when I went with a problem in my thumb - and then I had to take my
shirt off.

Most of my problems have been resolved with a programme of exercises.
The exercises vary. It's easy to forget to do them or not get round
to doing them, but it really seems miraculous what happens when you
actually do your 20 minutes of whatever-it-is each day.

Sometimes you get some massage. I thoroughly recommend developing a
condition that requires a weekly neck and shoulder massage, especially
as my local physio is an easy 10 mins walk away and did 8am
appointments, so I could have a bit of a lie in, amble to the physio,
nice massage (desperately working at not dozing off on the couch), and
get to put in on the timesheet as 'sickness' when I finally get to
work.

Tell them whatever they ask - I've never been asked things I couldn't
answer (it's always been things like 'how often do you do x?', rather
than the sorts of question doctors in hospital ask - 'have any of your
great uncles ever been exposed to mombasa virus?'😉. Their favourite
question seems to be the easy one - 'does this hurt?'.

Regarding asking them things - make sure you know what the exercises
are supposed to be and how you do them. They will probably make you
do them while they watch, so this shouldn't be a problem. You could
ask if you should persevere if you think doing the exercise is making
something hurt worse.

Will it help? I've had lots of problems with my knees for the last 25
years or so. Physio is the only thing that's ever properly helped.

regards, Ian SMith
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Ian Smith said:

I have twisted bones in my legs - my feet point outwards more than
they should (and asymmetrically) and the knee joints (especially the
right) are prone to various problems.

Similar to mine, only its my ankles (particularly the left one) which
give me the grief.

Quoted message said:

I have been through repeated sets of physio, and now know that if I
have problems all I really need from the GP is a referral to a physio
- I've never had a knee problem solved by a GP.

The only problem I had was it took a month off work to get an
appointment. When I finally did get to see the physio she said I was a
"typical cyclist"[1] and after the "Dance Of Despair And
Disillusionment" ("Being John Malkovich" fans will know what I mean)
gave me some remarkably simple exercises to do. I went from cripple to
fit in about three days - it may have been less if I had got a prompt
appointment.

[1]I took it as a compliment at the time, but later I realised that she
probably identified this from the areas of my body which had a smaller
range of movement than normal.

JimP

--
Let's think the unthinkable, let's do the undoable, let's prepare to
grapple with the ineffable itself, and see if we may not eff it after
all. - DNA

Ian Smith said:

Wear clean and presentable underwear.

What you trying to say man! I always do!!! But, just to be on the safe
side, I'll put my best black lace basque and lace-topped stockings on
;- )

Cheers for t'other info - I'm quite optimistic now! :- )

Blonde said:

Ian Smith said:

Wear clean and presentable underwear.

What you trying to say man! I always do!!!

Ah well, my 'lessons learnt' with respect to physio were learnt from
about the age of 15 onwards. Teenage boys are not necesarily entirely
fastidious in their choice of under-garments.

The main issue is not to cycle to the appointment in padded cycling
shorts with nothing underneath - then it's more tricky when they ask
you to take your trousers off.

regards, Ian SMith
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Ian Smith said:

Blonde said:

Ian Smith said:

Wear clean and presentable underwear.

What you trying to say man! I always do!!!

Ah well, my 'lessons learnt' with respect to physio were learnt from
about the age of 15 onwards. Teenage boys are not necesarily entirely
fastidious in their choice of under-garments.

Note to any teenage boys reading:

While Ian is absolutely right that you should wear a clean pair of
bills when visiting the physio, don't go so far as to follow Blonde's
advice of "best black lace basque and lace-topped stockings".
Questions might get asked.

Tim

Tim Hall said:

Ian Smith said:

On 23 May 2006 07:27:40 -0700, Blonde <[email hidden]>

Quoted message said:

Ian Smith wrote:
> Wear clean and presentable underwear.

What you trying to say man! I always do!!!

Ah well, my 'lessons learnt' with respect to physio were learnt from
about the age of 15 onwards. Teenage boys are not necesarily
entirely fastidious in their choice of under-garments.

Note to any teenage boys reading:

While Ian is absolutely right that you should wear a clean pair of
bills when visiting the physio, don't go so far as to follow Blonde's
advice of "best black lace basque and lace-topped stockings".
Questions might get asked.

I read that as "don't go so far as to follow Blonde"

And the questions I was thinking would get asked were

"So, Mr N, I see from your CV you are trained in other fields. Why is it you
have suddenly decided to become a physiotherapist's assistant?"
--
Ambrose

Tim Hall <[email hidden]>typed

Quoted message said:

Note to any teenage boys reading:

Quoted message said:

While Ian is absolutely right that you should wear a clean pair of
bills when visiting the physio, don't go so far as to follow Blonde's
advice of "best black lace basque and lace-topped stockings".
Questions might get asked.

Note to any teenage boys reading:

Wear TWO pairs of underpants; physios are often young attractive ladies
and you don't want to embarrass them or yourself. Trust me I'm a
doctor...

--
Helen D. Vecht: [email hidden]
Edgware.

IME doing some strength training is a good way to prevent the aches and
pains that are otherwise inevitable if you, like me, spend hours in
unnateral positions, either on a bike of in front of a computer. I
discovered Kieser a few months ago, and it's really helped with my
back/shoulder/nect pains, plus I can now mash like a barstewered.

Currently, there is only one Kieser club in the UK (Camden) but they
are supposed to be opening new ones soon. If the 'Right Said Fred'
vibe puts you off classic weight training studios, this might be the
answer...

sothach said:

IME doing some strength training is a good way to prevent the aches and
pains that are otherwise inevitable if you, like me, spend hours in
unnateral positions, either on a bike of in front of a computer. I
discovered Kieser a few months ago, and it's really helped with my
back/shoulder/nect pains, plus I can now mash like a barstewered.

Currently, there is only one Kieser club in the UK (Camden) but they
are supposed to be opening new ones soon. If the 'Right Said Fred'
vibe puts you off classic weight training studios, this might be the
answer...

I dunno, y'see I've done weight training for the past ten years. I had
knee trouble as a teenager, something to do with bone growth rate of
leg bones and knee caps being different - this was confirmed by X-rays
but I was told I would grow out of it. I had no pain at all in either
knee again after I was about 17 years old until last November in the
cold and wet, which is the only time my left one ever hurts, when it's
cold and wet, so I'm not sure if it's anything muscular.

Blonde said:

I dunno, y'see I've done weight training for the past ten years. I had
knee trouble as a teenager, something to do with bone growth rate of
leg bones and knee caps being different - this was confirmed by X-rays
but I was told I would grow out of it. I had no pain at all in either
knee again after I was about 17 years old until last November in the
cold and wet, which is the only time my left one ever hurts, when it's
cold and wet, so I'm not sure if it's anything muscular.

The idea behind strengthening the muscles around a joint is not so much
to avoid aches from weak muscles as to develop the muscles to stabilise
the joint itself. In the case where a pair of antagonistic muscles is
unevenly developed the stronger one may be pulling the joint off of its
ideal track. A therapist might suggest exercises aimed at developing a
specific muscle to try to stabilise the joint.

--
Dave...

dkahn400 said:

The idea behind strengthening the muscles around a joint is not so much
to avoid aches from weak muscles as to develop the muscles to stabilise
the joint itself. In the case where a pair of antagonistic muscles is
unevenly developed the stronger one may be pulling the joint off of its
ideal track. A therapist might suggest exercises aimed at developing a
specific muscle to try to stabilise the joint.

That's pretty much the story they give me whenever I go and see them.
The clever bit is in deciding which muscle - I've had pains that have
felt the same as last time, but the exercises I got last time didn't
help. The physio has given different exercises, and they have helped.

So it's not just a case of developing muscle strength in general
around the joint - it needs to be the right muscle, and consequently
the right exercise (as suggested above). As it happens, the only time
a GP gave me exercises, when I got to the physio, they asked me where
it hurt, prodded a bit, and then said "you haven't been doing xyz have
you - that would make it worse". Yes indeed, xyz was precisely what
the doctor ordered...

regards, Ian SMith
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"sothach" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

IME doing some strength training is a good way to prevent the aches and
pains that are otherwise inevitable if you, like me, spend hours in
unnateral positions, either on a bike of in front of a computer. I
discovered Kieser a few months ago, and it's really helped with my
back/shoulder/nect pains, plus I can now mash like a barstewered.

Or IME a body mechanic will look at your stance and skeletal position.
Fom this they will determine that if you adjust your underlying posture,
ie change your shoes then the rest of your body will be put back into a
more reasonable posture and the aches and pains caused by standing at the
slant
will go away.

Dave
who now wears one shoe with a higher heel than the other.
Thus balancing the pelvis, straightening the spine and removing pressure
on the knee ligaments.

Blonde' of urlhttp://groups.google.com/url said:

Ian Smith said:

Wear clean and presentable underwear.

What you trying to say man! I always do!!! But, just to be on the safe
side, I'll put my best black lace basque and lace-topped stockings on
;- )

Assuming that this implies you are female, then for knee trouble I recommend
the wearing of a skirt. Either a skirt short enough so that the knees can
be observed, or my preference one that can be quickly pulled up to reveal
the knees, then let down again afterwards while cycling back from the
appointment.

Do tell your physio quite how much you cycle. I had knee trouble in the
winter. The doctor recommended leg raises to strengthen the muscles. On
learning of my (modest 40 miles a week) cycling habit, the physio pronounced
that leg raises were unlikely to make any difference - and he was right. He
had some much more strenuous ideas, which worked.
--
Steph Peters
Chorlton Wanderers Cycling Group
Monthly slow and easy rides from South Manchester
http://www.sandbenders.demon.co.uk/cycling/chwan.htm

Blonde said:

Hello all,

I have booked myself into a sports physio session next week, as I have
been having knee pain for about four weeks and my GP was useless. The
first session is one hour, any subsequent sessions will be half an
hour. I don't know if this is an injury or an underlying condition and
I don't even know if it's cycling related or not, although it does seme
to be brought on by cold wet weather, regardless of mileage.

I've never had any treatment like this before, so what should I expect?
What qualifications/experience should they have? What do I need to tell
them? What should I ask them? How likely is it they can actually help
me?

I have formed my view of physios from a sample size of one, so it may
not be entirely accurate. Physios are wonderful people. After my crash
I saw 101 doctors and travelled all over the country to see them. They
x-rayed, scanned, prodded and poked[1] and, to a man, did nothing more
than suck their teeth, send the bill and ask me to come back in 6
weeks.

The physio, OTOH, explained to me precisely what nerves, muscles and
bones were damaged. She told me what this meant and how things worked.
She then, unlike the doctors, /made me better/. Not 100% but an awful
lot.

Physios are stars and I don't think my view is too coloured by the fact
that mine is female and heartstoppingly good looking!