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What are complex neurological symptoms and why are they singled out?
The complex neurological conditions section has been dedicated to neurological diseases that may require a special set of assessment and treatment skills. All physiotherapists have training in these conditions; however, not all therapists treat these conditions regularly. Depending on their presentation, a therapist with more experience treating these conditions may be necessary.
How do I know if I need a more experienced physiotherapist?
The only way to truly know is to contact the clinic you're interested in directly. In some cases, booking an assessment is necessary before anyone can determine the most appropriate therapist for you. If you received an assessment from a therapist who does not feel confident in treating you, they should be referring you to a more appropriate therapist.
Why isn't my condition listed?
The intent of this section is to improve access to treatment to some of the most common neurological conditions. The intent is not to diminish the impact of other conditions. There is a good chance your condition will be listed soon. If it is not, please keep in mind that physiotherapists treat many conditions. The list is very extensive and Physio Roots does not plan to list them all. If you have a diagnosis and are wondering if physiotherapy can help, call a clinic and ask them! Another good resource is Physio Can Help
Physiotherapists practicing animal rehabilitation are trained at evaluating your animal's, bones, joints, muscles and nervous system. They have undergone additional training to learn about animal movement, pathology and anatomy. Their goal is to identify the nature or cause of an injury and provide solutions to relieve pain and restore movement & function.
Cardiorespiratory physiotherapy is the practice of physiotherapy to improve cardiovascular and pulmonary function. It is commonly practiced in hospital settings to treat a variety of conditions that limit oxygen delivery to the blood stream. In acute scenarios, cardiorespiratory physiotherapy can be life saving. The physiological principles of cardiorespiratory physiotherapy are far reaching and can be used to help many different patient populations, from patients with acute and chronic diseases to top-level athletes.
Chronic pain is complex and this short description will not suffice as an explanation. An excellent resource for anyone interested in pain is the book "Explain Pain" by David Butler and Lorimer Moseley. To learn a little bit more about chronic pain, follow the link below.
Physiotherapy forms an integral part of a multi-disciplinary treatment for chronic pain. Most physiotherapists treat chronic pain of various forms on a daily basis. Some therapists choose to take additional education in pain sciences to help them distinguish between variations of chronic pain and to expand their treatment options. Pain sciences is a rapidly growing field and our knowledge of chronic pain has expanded greatly in recent times.
Patients recovering from cancer are faced with a number of secondary complications from cancer and side-effects from cancer treatment. Physiotherapists are in a an excellent position to help patients reduce cancer related fatigue, deconditioning, nerve damage, lymphedema, incontinence and much more.
Orthopaedics is the most common area of practice for physiotherapists. Physiotherapists practicing primarily in orthopaedics are known for using a combination of hands-on skills (manual therapy), treatment modalities (ex. IMS) and exercise to help restore movement, eliminate pain and return their patients to full function. Therapists must have knowledge of orthopaedics in nearly all areas of practice. To understand human movement, having a good foundation in orthopaedics is necessary.
Neonates, infants, children and adolescents can all benefit from physiotherapy. Physiotherapists play a role in the early detection and treatment of health problems including developmental delays as a result of various diseases and disorders. Paediatric physiotherapists work with children and families to maximize participation at school, home and recreational activities.
In the view of Physio Roots, a check-up / screening from a physiotherapist should be as important as a check-up with your doctor, especially for Seniors. Physiotherapy can help patients maintain optimal health & independence and maximize quality of life throughout the aging process. Therapists use valid and reliable tests and measurements which help them to create individualized exercise programs. With proper guidance and some dedication, physiotherapy can help you build and maintain physical resiliency.
Physiotherapists practicing in the area of Women's Health have focused their practice on health issues relevant to women. Pelvic health physiotherapy is a component of Women's Health. Therapists focusing on women's health may or may not provide pelvic health physiotherapy services. For more information, check out the Women's Health Division of the Canadian Physiotherapy Association.
Advanced / Specialty Training
Certified Hand Physiotherapists have taken a special interest in treating hand injuries. To become certified, therapists must have practiced physiotherapy for a minimum of 3 years, have mentored under a certified hand therapist and have completed a minimum of 4000 hours of direct experience treating hands. If all of the aforementioned are fulfilled, the physiotherapist must pass an exam to become certified.
1. Canadian Society of Hand Therapists (2019). About Us. URL: https://www.csht.org/ Retrieved February 23, 2019.
Clinical Specialists are leaders in a specific area of practice of physiotherapy. The Clinical Specialist program was developed by the Canadian Physiotherapy Association (CPA). All of the clinical specialists in Canada can be found on their website. According to the CPA (2019) clinical specialists have demonstrated advanced clinical competence, leadership, continued professional development and research within their specialty. To become a Clinical Specialist, individuals must be certified by the Physiotherapy Specialty Certification Board of Canada (PSCBC).
*Please note that Physio Roots (currently) does not have filters to differentiate between practice areas of Clinical Specialists.
1. Canadian Physiotherapy Association (CPA) (2019). Clinical Specialty Program. URL: https://physiotherapy.ca/clinical-specialist-program. Retrieved February 23, 2019.
Recovery after a concussion can be challenging and is best approached with a multidisciplinary (team). Physiotherapists play an important role on that team. A closely monitored therapeutic exercise program is an important part of rehabilitation. Vestibular rehabilitation is also commonly needed after concussion, which is a form of rehabilitation in which physiotherapists are well trained. Carefully graded and specific manual therapy techniques (hands-on treatment) can also help with recovery; many post-concussion symptoms can be generated from the neck and respond well to manual therapy.
In some provinces physiotherapists can prescribe diagnostic imaging (ex. x-ray and MRI) with additional training. If a physiotherapist is unable to prescribe imaging, they will typically refer patients to their family physician. Physiotherapists may recommend imaging if they think it is going to change a patient's course of care. By the time a physiotherapist recommends imaging, they usually suspect a problem with a very specific area of the body after performing a very thorough orthopaedic assessment and having treated the patient. Because clinics on Physio Roots may have other professionals working at them, it may not be the physiotherapist who prescribes diagnostic imaging at the clinic you're looking at.
The Diploma in Advanced Musculoskeletal Physical Therapy (Dip. AMPT) is awarded by the APTEI (Advanced Physical Therapy Education Institute) to physiotherapists who complete the APTEI's 5 Advanced Programs as well as their written and practical examinations. These courses are usually 4 days in length; each course focuses on a different region of the human body and pain science. Physiotherapists enhance their diagnostic clinical reasoning and learn new treatment techniques to help their patients. Treatment techniques include manual therapy (hands-on treatment), therapeutic exercise, taping, pain education and much more!
The APTEI offers many continuing education courses to physiotherapists. It is important to note that while there are few physiotherapists with the Dip. AMPT, many physiotherapists take courses through the APTEI. This means there is a good chance your physiotherapist uses a treatment technique obtained through APTEI education!
Physiotherapists with a Diploma in Sport Physiotherapy have experience treating athletes of all levels on and off the field and are qualified to work with Canada's highest level athletes. They have been trained through an education system provided by Sport Physiotherapy Canada (SPC). To acquire their diploma therapists must mentor under experienced therapists and pass written and practical examinations.
1. Sport Physiotherapy Canada (2019). About Us. URL: https://www.sportphysio.ca/about-us/. Retrieved February 23, 2019.
Fellows of the Canadian Academy of Manipulative Physiotherapy (FCAMPT) physiotherapists have undergone extensive post-graduate training in orthopaedic assessment and treatment. FCAMPT is an internationally recognized designation through the International Federation of Orthopaedic Manipulative Therapists (IFOMPT).
To receive their diploma, physiotherapists must complete several practical and written examinations as well as clinical mentorships. They must demonstrate profound knowledge of scientific research applicable to physiotherapy and the neuromusculoskeletal system. It typically takes about 6-years to receive the FCAMPT diploma, although it can be achieved faster. FCAMPT therapists are known for their hands-on skills.
*Many physiotherapists have taken courses that are part of the FCAMPT curriculum but do not have the FCAMPT designation. You may see therapists mention that they have "orthopaedic/manual therapy levels" (1-5) or their "intermediate diploma."
Physiotherapists with training in pelvic health (or the 'pelvic floor') are highly trained at assessing and treating pain and dysfunction associated with the pelvic region. Dysfunction of the pelvic region can lead to many complications, including (but not limited to) low back pain, hip pain, incontinence and increased urinary urgency. In some countries, a pelvic health physiotherapist is part of the public healthcare pathway for every woman prenatal and postnatal. Unfortunately Canada is not one of these countries (yet).
More and more people are discovering that physiotherapists can help with TMJ problems. The TMJ is just like any other joint in the body and physiotherapists are trained at assessing and treating it. The same treatments that can be applied to other areas of the body can be used for the TMJ. Physiotherapists can help to increase TMJ mobility, decrease pain and reduce or eliminate popping and clicking.
Dysfunction in the vestibular system is quite common and can lead to vertigo, dizziness, visual disturbance, nausea, fatigue and difficulty concentrating.
Physiotherapists perform 'vestibular rehabilitation', which involves assessment and treatment of the vestibular system. There is a large body of scientific evidence supporting vestibular rehabilitation, including but not limited to use of specific exercises and manual therapy techniques. Vestibular rehabilitation is also a crucial aspect to post-concussion rehabilitation.
Cupping is an ancient treatment technique and there are many traditional uses. Physiotherapists generally use cupping to treat the myofascial system (muscles and connective tissue). Many patients report improvement in muscular pain and range of motion immediately after treatment.
The cups work through a vacuum that is created between the cup and the patient's skin. Like other forms of treatment, their therapeutic effect is believed to occur by promoting circulation.
Intramuscular Stimulation (IMS) is performed by inserting dry needles (acupuncture type needles) into myofascial trigger points (muscle knots). Simply spoken, IMS works by 'resetting' the muscle to its normal resting state. When placed properly, the dry needles cause the muscle to twitch. After the muscle twitch occurs, there is a restoration of normal nerve activity, resting muscle tone and consequently, blood flow. By restoring the aforementioned, muscle pain and function can improve, as well as range of motion of any nearby joints. The effects of IMS are far reaching; the impact is has on the nervous system is used by many therapists to treat more than just local tissues.
Despite the long name, IASTM is a group of well known manual therapy treatments. Physiotherapists performing IASTM usually use a stainless-steel instrument to mobilize soft tissue; however, there are a variety of instruments available. Depending on the instrument being used, the intent of IASTM may be different. Therapists usually use the stainless-steel tools to treat fascia, which is a very strong tissue and is like a vacuum-seal around our muscles. By applying gentle pressure over skin with the instrument, practitioners try to target the fascia to reduce adhesions created by a healed/healing injury, improve circulation and promote healing. Instruments may be used for different purposes; it is best to discuss the treatment with your provider prior to commencing.
Laser stands for "Light Amplification by Stimulated Emission of Radiation". Light from a laser is of one color (monochromatic), parallel (collimated) and have the same frequency (are coherent). When this type of light makes direct contact with our body it produces a cascade of cellular reactions which are believed to improve tissue healing, relieve pain and act as an anti-inflammatory agent.
Medical Acupuncture or "Western medical acupuncture" is traditional Chinese acupuncture with the scientific method applied to it to explain its effects. Specific treatments and protocols that were derived from traditional Chinese acupuncture may be applied, but the theory driving the treatments may be different than what comes from Traditional Chinese Medicine (TCM). For more information go to read more.
Acupuncture can have many positive effects on all bodily systems. Therapists may use acupuncture needles on their own, or with electrical stimulation. Acupuncture may also be combined with other treatments for greater effect. Intramuscular Stimulation (IMS) is not to be confused with acupuncture. For more information read the article regarding IMS.
Muscle Release Techniques (MRT) form a broad manual therapy category on Physio Roots. There are several patented treatment techniques that can be categorized under MRT. MRT techniques aim to change muscle tone to improve range of motion, pain and overall function. Techniques can be performed many different ways depending on a number of factors. Some common techniques involve actively or passively stretching a muscle throughout range of motion, simply applying mechanical pressure to an area, having patients alternate between contracting and relaxing or changing joint position. Most physiotherapists practicing in orthopaedics perform some form of MRT on daily basis.
Inflammatory prolotherapy (proliferation therapy) involves the injection of natural substances into specific tissues within the human body. The goal of prolotherapy is to promote healing by creating mild inflammation. Prolotherapy is often used to treat stubborn tendon and ligament injuries. Physiotherapists may recommend prolotherapy for joint problems to help stimulate healing and promote stability.
PRP Injections (platelet rich plasma injections) are another form of prolotherapy. The patient's own platelets are concentrated using a centrifuge, chemically activated and re-injected into the patient at specific site/target tissue. Platelets are part of the natural healing process. After an injury, they migrate to the site to form a clot, release growth stimulating chemicals and to signal other cells to migrate to the injury site. These properties are taken advantage of during PRP injections, with the goal of maximizing the rate of healing of the target tissue. Like inflammatory prolotherapy, PRP injections are often recommended for poorly vascularized tissues such as tendons and ligaments.
Shockwave is the application of sound waves of very specific characteristics to the human body. It is believed shockwave improves healing by stimulating certain cells and chemical growth modulators within our tissues. Because of these effects. shockwave is most often used to treat tendons, ligaments and connective tissue. These tissues have poorer blood supply than most other tissues and consequently longer healing times. Therapists try to maximize the healing potential of the affected tissue by using shockwave to stimulate local cellular processes.
Physiotherapy is sometimes not the first profession thought of when it comes to spinal manipulations. The truth is, physiotherapists have been performing manipulations for as long as the profession has been around.
Spinal manipulations are simply a joint manipulation of a spinal joint. Joint manipulations are a very specific movement at a joint and can have a powerful effect on the body. Joint manipulations often have a loud cracking or popping sound associated with them. This sound can be explained by movement of gas molecules within the joint, otherwise known as a cavitation.
Manipulations have shown to release a variety of natural chemicals in our body that can have profound impacts on our nervous system and can effectively reduce pain and muscle tension. These effects tend to be short-lived; however, in combination with other treatments it may be possible to keep them around.
Some provinces provide funding for limited physiotherapy when income is below a certain value. In most cases, clinics must be have a contract to provide low-income coverage.
Unfortunately, Physio Roots does not have information specific to each province at this time.
Some provinces provide funding for limited physiotherapy after receiving a surgery. Conditions of this service will vary by province.
Unfortunately, Physio Roots does not have provincially specific information about this service at this time.
Clinics in this category are able to provide rehabilitation services for a work injury insurance provider. Depending on the province, the name/entity of the insurance provider will be different; for example, in Ontario it is WSIB and in Alberta it is WCB. Policies and procedures will also vary depending on the province.
In general, the first visit with the physiotherapist is your assessment. If it is a work injury, your physiotherapist will submit all the necessary paperwork and await approval. If your claim is approved, your appointments should covered by the insurance provider.
The policies and procedures governing claims for a work injury are usually very regulated. For more information, please contact the clinic providing this type of service.
Automobile insurance is provincially regulated; policies, procedures, regulations and legislation will vary by province. Physiotherapy is typically a service that is covered by automobile insurance after any accident. Physio can be a crucial aspect to your recovery!
Most physiotherapy clinics provide services to victims of motor vehicle accidents. Physio Roots has provided an option for clinics to specify whether or not they provide this service.
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