Challenging six misconceptions about Physiotherapy.

Ignorance is bliss? Try saying that to someone in pain or recovering from an injury!  

When it comes to your body and health, information is power. Specifically, truth and facts can empower you to take charge of your health.  

Misconceptions can be likened to pesky parasites that invade your mind and stop you from taking that first step, I.e. booking a physio appointment, especially when you need it most.  

Let’s correct them, shall we? 

A Physiotherapist can be substituted by massage therapists or chiropractors

  • All 3 professions, although seemingly similar, in that they all deal with the musculoskeletal system, are varied in their foundational practices.

  • Physiotherapy is the art of assessing and analyzing the human body and then formulating a treatment plan accordingly. Physiotherapists are key members of pre- and post-surgical rehabilitation teams in different departments such as Cardio-thoracic, neurological and Orthopedic specialties.

  • With a strong foundation in the sciences, physiotherapists are experts in assessing movement and functionality. 

  • If a proverbial door stands in the way of pain-free movement, assessment is the key and the treatment is the lock. Without the right key, you will never open the door.

     

  • Without a detailed assessment, it is impossible to formulate the correct and most efficient treatment plan. This is what sets us apart from other healthcare professions.

     

  • In addition, physiotherapists provide you with an individualized exercise regime focused on maintenance and/or strengthening.

     

A doctor’s referral is required

 

  • Physiotherapists are autonomous healthcare professionals who use evidence-based strategies in the assessment and treatment of their clients. Owing to the absence of drug prescriptions and surgical intervention, it is entirely safe to see a physiotherapist without a doctor’s note.

     

  • However, a doctor’s recommendation is the most common reason for clients seeking physiotherapy services. Changing public perception is one of the <reasons we founded> Revere Physiotherapy.

     

  • Chances are you have not been made aware of the advantages of preventive physiotherapy, which is a segue for the next misconception.

     

Physiotherapists only treat patients with pain or in need of rehabilitation

  • While the awareness of physiotherapy in rehabilitation is quite strong, the full scope of physiotherapy is not entirely known to the general public (hence this post).

     

  • Whether you’re a weekend warrior dreaming of being an ace or a weight enthusiast trying to perfect your form, a visit to your physiotherapist will only help you achieve your goals faster.

     

  • Preventive physiotherapy is for anyone, anywhere on the athleticism spectrum, who wants to push their physical performance to further limits in a safe and effective way.

     

Physiotherapists treat general health but I have a very specific problem

  • Aren’t we glad you brought this up? 

     

  • Much like all other medical professions, physiotherapists are perpetually learning and expanding their scope. 

     

  • There is a tremendous amount of continuing education courses, specific to different conditions or regions of the body, that are available to physiotherapists and it is up to the individual to continually expand their knowledge and expertise. 

     

  • Looking through bios or descriptions of the physiotherapist’s additional training will give you a clear picture of a good fit for your needs.

     

All physiotherapy education is offered in school, and therefore all physiotherapists have the same experience and skills 

 

  • Wrong again. Education to become a physiotherapist is fairly standard for the general student. In most Canadian schools, it requires a Bachelor’s degree and a ~2-year Master’s degree in Physical Therapy.

  • There are some Canadian schools and some international schools which have a Bachelor’s degree in Physical Therapy as well. There is no preference between either of these routes and any graduate of these programs is more than qualified to practice physiotherapy.
     
  • Through our master’s program, we learn how to analyze and diagnose conditions, formulate treatment plans to solve those diagnoses, and even screening potential red flags (in which we would refer you to your doctor). 

     

However, more specific skills are acquired through additional certifications which require a financial investment. At Revere, our team spends more than $5000 annually to equip themselves with the latest techniques obtained from ongoing research. 

 

If my back hurts it’s probably injured

  • This one is all too common and not entirely accurate. While it’s possible that the pain could stem directly from the source of injury, it’s important to remember that the musculoskeletal system is beautifully complex and interconnected.

     

  • In the process of protecting one aspect of your body other parts can stiffen/loosen up. Your physiotherapist will assess joints above and below your painful stimulus to accurately diagnose the problem and ensure a thorough recovery.

     

  • That should clear the most common misconceptions for you. If this post was useful for you do share it with your friends to help educate and spread awareness about physiotherapy.

     

If you have further questions feel free to reach out to us at info@reverephysio.com

or call us at 604-566-5108 

We offer complimentary 10-minute phone calls with our expert physiotherapists to answer all your questions. 

You could also leave your questions in the comments below and we’ll be sure to address them in subsequent posts.  

Try a Free Consultation

At Revere,we offer a free phone consult for you to determine if we’ll be a good fit. Our senior physiotherapists will speak with you to alleviate any apprehension you have about the Physiotherapy process, Insurance or the clinic policy.

*Please leave us a voice note If we are not reachable.

Recent Posts

Everything you must know about Concussions and the role of Physiotherapy

If you have received a diagnosis of Concussion and you are curious about return to pre-concussion activities, this post is written for you. We understand how frustrating it can be to be recommended rest when you feel absolutely fine. But here is why being patient with yourself and your body can be a life saver.  

We’ll start at the very beginning to ensure you can see the big picture. 

The brain, as we know it, is a jello-like substance encased within the bony structure of the skull. In order to simplify concussions, its useful to imagine an egg. A concussion is like shaking the egg suddenly and vigorously. While the shell remains intact the contents of the egg are shaken up regardless.  

For a long time, it was considered that concussions were caused due to the brain slamming against the skull resulting in bruising of the outer surfaces. However, current hypothesis states otherwise.  

What is a concussion? 

A concussion is a traumatic brain injury (TBI).  It often happens due to trauma to the head. Broadly, it is anything that causes a quick acceleration and deceleration to the brain.   

What this potentially means is that taking a hard hit to the body could still give you a concussion.   

What causes symptoms? 

  • Disputing earlier theories, concussions are now believed to stem from a stretching of brain tissue that occurs when it is ‘shaken’. 
     
  • In the absence of a concussion, all nerve cells are active or ‘turned on’ to serve a specific function such as a thought or an action. However, following a concussion, the nerves are stretched and they begin firing continuously or randomly without a purpose resulting in symptoms like headaches, nausea etc. Essentially the nerves have been tricked into turning on! This is called the excitatory phase of concussion.

     

  • All this unnecessary activation and firing has a huge cost- energy! Imagine a battery of energy that gets recharged after a full night of sleep, every time you perform a task you lose some charge on your battery.

     

  • Now, try to imagine your nerves firing unnecessarily and using all your energy that was supposed to be saved for work, grocery shopping and cooking dinner. With all that energy used up, it is most likely you are feeling exhausted without exerting your body at all. This phase is called the spreading depression and is usually observed a few hours after the concussion

     

  • Your energy stores continue to plummet over the next couple of days until you hit a peak low. After that your energy starts to perk and this is when recovery happens. 

     

It’s important to remember you might start to feel better around day 4 or 5 but it takes an average of 10 days to restore your energy back to pre-concussion levels. You have to take it slow! 

 

How do you recognize a concussion? 

As far as we know, there is currently no single test to diagnosis a concussion. Health care practitioners try to use a variety of tests (i.e. physical exertions, visual, loss of consciousness, etc.) but they’re not a definitive way to rule out a concussion. 

  • The first thing to be aware of are the “red flags”.  These are observable signs or complaints that an ambulance should be called if no healthcare professional is available.  These include: neck pain/tenderness, double vision, weakness or tingling/burning in arms or legs, severe or increasing headache, seizure or convulsion, loss of consciousness, deteriorating conscious state, vomiting, and increasing restless, agitated or combative.

     

  • If none of the above are present there are some visual clues such as: lying motionless, slow to get up, disorientation/confusion, blank/vacant look, balance issues, or facial injury.   
  • Concussed individuals may also report any of the symptoms: headache, dizziness, neck pain, nausea/vomiting, pressure in head, blurred vision, balance problems, light/noise sensitivity, feeling slowed down, feeling like “in a fog”, don’t feel right, difficult concentrating/remember, fatigue or low energy, confusion, drowsiness, trouble falling asleep, more emotional, irritable, sad, and nervous/anxious.

     

What to do if you suspect you have a concussion? 

  • Immediately stop whatever activity you may be doing.  Continuing to “power through” will potentially increase the duration and severity of your injury.

     

  • Seek immediate medical attention (ER) if red flags are present and if red flags are not present, you still should see your doctor as soon as possible.  If you are diagnosed with concussion and subsequently your condition continues to deteriorate, go back immediately.

     

A second concussion or multiple concussions before you have recovered from your first one can be potentially dangerous and is called the second impact syndrome. It is absolutely vital that you seek medical help immediately. 

 

How is a concussion treated? 

  • Concussion management is a step-by-step process that takes time.  One of the most difficult things within concussion management is having the patience to allow your body to recover.  A lot of patients want to be better yesterday.  Unfortunately, concussions are just something you can’t “rush” or “push through”.  

     

  • Treatment is individualized and targets the medical, physical, and psychosocial domains.  This will usually, include, an individualized symptom-limited aerobic exercise program and a plan to treat cervical and vestibular dysfunction.  

     

  • It is absolutely normal to experience anxiety, depression or even Post Traumatic Stress Disorder. You are not alone in experiencing these symptoms. A therapist that specializes in cognitive behavioral therapy can be extremely helpful for any persistent mood or behavioral issues.

     

Physiotherapy role in planning your return 

Whether you’re planning your return back to school, sport, or work, many of the protocols/strategies follow a similar framework. 

  • Absolute rest (24-48 hours)

     

  • This is a time period where you want to just take it easy.  Do what you feel comfortable doing and no need to push through unnecessarily.

     

  • Light physical and cognitive activity.

     

  • Begin going on some short walks and light reading.

     

  • Slowly build your ability to tolerate either of these things from 5 minutes up to 45 minutes.

     

  • After you finish doing any walking/reading, it should not take more than an hour to return back to how you felt before you started walking/reading.

     

  • 3–4-hour day of work/school with workload accommodations as needed.

     

  • Ensure manageable work hours, workload, and work environment.

     
  • Full day of work/school with workload accommodations as needed.

     

  • Ensure manageable work hours, workload, and work environment.

     

  • Full return to work/school.
     

If returning back to sport: 

  • Sport specific exercise

     

  • Non-contact training drills

     

  • Full contact practice
     

  • Return to sport

     

In some frameworks, a treadmill test between step 5 and 6 is used to assess the degree of exercise tolerance.  In each of the steps above, a minimum of 24 hours must pass by without an increase in symptoms in order to move onto the next step.  When dealing with a return back to sport, it is important to not return until you have been cleared to do so by your physiotherapist or your physician. 

That said, every concussion is different and can be unique in presentation. Fortunately, the body of research into the nature of concussions and the concussion management is growing at a rapid pace due to increased awareness.
 
 

Generic advice and protocols on return to work can be a guideline but that’s all they are- a guideline.  A consultation with an expert physiotherapist who is Certified in the Complete Concussion Management protocol will be your next best step to make informed decisions that are individualized to your recovery and your body.  

 

At Revere Physiotherapy, our inhouse Concussion experts are happy to assist, support, guide and empower you on your recovery journey. Schedule an appointment now. If you have any questions or concerns reach out at info@reverephysio.com. We offer complimentary phone consultations for you to decide if we’ll be a good fit. Give us a call at 604-566-5108. 

 

If you have recovered from a concussion recently comment below and tell us your experience with recovery and how long it took to return to work. Also share this article with friends and family, especially those with young children who are active in sports.

4 considerations for Physiotherapy after work-related injuries 

Injuries or diseases resulting from the workplace can be quite debilitating as they impact multiple areas of your life. In some cases, it might seem difficult for you to determine that symptoms are originating from your workplace. However, if you feel symptoms are being exacerbated at work it might be helpful to talk to your physiotherapist to receive guidance and confirmation. 

  • WorkSafe, BC is the provincial agency that is responsible for work-related impairments and diseases. They are dedicated to ensuring you receive medical care at the earliest in an accessible manner. 

While some work injuries can be treated with medical care, there are others that will require varying degrees of rehabilitation. Workplace injuries that will require rehabilitation can include: 

  • Musculoskeletal injuries such as Repetitive Strains and sprains 
  • Falls 
  • Cuts, lacerations, amputations and more.

     

If you are experiencing any symptoms WorkSafe BC provides guidelines on reporting your injury. On receiving a claim number, you are eligible to access our physiotherapy services.  

At Revere, we have a contract with WorkSafe BC, which means you don’t need a doctor’s note or referral to access our services. All you need is your claim number to begin your road to recovery.  

We understand that choosing the right healthcare provider can seem daunting, how can you possibly know the best one for you, right? As experienced physiotherapists, working in the field for 15 years, we are offering you some considerations. 

Here are 4 things to keep in mind when looking for Physiotherapy after a work-related injury- 

  1. Cost and coverage 

In order to fully understand WorkSafe benefits we will need to compare 2 different systems; the one before and the one after June 1, 2022. 

  • Before June 1st, 2022: Physiotherapy sessions could be booked only when the case was approved and a claim number was presented. Furthermore, you would be eligible for 6 weeks of treatment, with a frequency of twice a week. After 6 weeks, you would be re-assessed to determine the next steps.

  • The physiotherapy clinics were paid ~$450 for every 6-week block, which was about $40 per session far lower than the rate for private physiotherapy sessions. To make up for the discrepancy, physio clinics charged a user fee which had to be paid out of pocket. This amount could not be reimbursed from WorkSafeBC.

  •  As you can imagine, having to pay for medical care when you couldn’t work at all was probably stressful. Science has revealed that stress negatively impacts your body’s healing process.

  • After June 1st, 2022: You are now eligible to access services with only a claim number without having to wait for the approval.

  • Additionally, clinics were allocated more funds; $83 per session. You are able to receive 6 weeks of treatment up to 15 sessions. While this is a significant increase, private physiotherapy rates can range from anywhere between $90-110 per session. This is the reason most physiotherapy clinics charge user fees. This impacts you, the patient in many ways. You may not be able to focus on maximum recovery and may not be able to receive as many treatment sessions as you’d require.

At Revere, we understand your financial burden at a time such as this. That’s why we’ve pledged to offer the highest quality of physiotherapy care at ZERO cost to you. We do not charge user fees to prioritize your recovery with minimal stress.

      2. Duration of session
  • Best practices for physiotherapy include a 20–30-minute session. This is adequate time for assessment, treatment and ongoing feedback.

  • When you are looking to book appointments, you may want to keep that in mind. In order to make the most of a physiotherapy session and return to work duties, you will want an effective physiotherapy session.

     3. Type of intervention offered, quality of care 
  • Any injury is best treated with hands-on, one on one care. At Revere, we pride ourselves on exactly that. Our specialty is manual therapy. We do not stack multiple clients all at once. We do not hook you up to machines as your physiotherapy intervention neither do we delegate to assistants. We believe in quality care and that’s what we offer. We don’t charge additional fees for Dry Needling or Shockwave therapy if indicated.

  • Return to work is harder when long breaks are taken; the break becomes counter-intuitive. Instead of feeling healthy and strong, you may begin to feel idle which adversely impacts your mental health. Our goal is to help you return to work at the earliest so you can be engaged in something that boosts your morale and self-esteem.

  • Your physiotherapist will talk you through your options, sometimes a gradual return to work may be suggested. You may continue to access services and coverage through WorkSafeBC provided you need more intervention. You will also be given exercise prescriptions and adjustments at your workplace. You can be reassured that all the support you need will be provided to make a safe return to work.

  • Depending on the type of injury you may need more intervention. Soft tissue injuries usually heal within 6 weeks. However, this 6-week block can be extended if the need arises.

In case of fractures, ligament tears or surgery, the same process is followed, but with a longer time frame for healing and rehabilitation.

     4. Interdisciplinary Collaboration 
  • Physiotherapists are well placed within the service delivery model to refer to other services as deemed necessary. We use our clinical reasoning to determine additional services that will potentially benefit you and maximize your recovery.

  • Worksafe BC has an Occupational rehab program which is a full-time rigorous intervention. This is an extensive program with a full-fledged rehabilitation team supporting your recovery.

We hope this article gave you clarity on physiotherapy after a work-related injury. Book an appointment with our expert physiotherapists to get started on your recovery. If you have any questions reach out to us at info@reverephysio.com.  

Let us know in the comments what your experience of physiotherapy services has been like and how long it took. It will be useful for other readers to get an idea of recovery and return to work.

Share this article with those you think will benefit from understanding WorkSafe BC and the physiotherapy process.

Physiotherapy after accidents: 4 things to consider

A motor vehicle accident is a traumatic experience. A violent impact on the body can leave lasting effects, in the form of severe injuries or aches and pains that persist for days, even weeks.  

In the Lower Mainland alone, ICBC states that up to 22% of all crashes are casualty crashes- crashes that result in injury. 

If you have been in an accident as a driver, passenger, pedestrian or cyclist, in BC you are able to report it on the ICBC website. After you have submitted the relevant documents, you will receive a claim number. This number will enable you to access healthcare service providers with immediate effect.  

With all the paperwork, vehicle damage, physical injury and psychological impact following an accident, we understand that choosing the right service provider for you can feel daunting. We created this simple checklist that should make it a tad easier for you.  

Although we stand by our promise of offering only the best physiotherapy care, should you opt to visit other clinics, this checklist will remain a useful framework on to base your decisions during this incredibly stressful time.  

Here are 4 things to consider when choosing a service provider. 

  1. Cost
  • ICBC provides a predetermined amount of coverage for different services, but it has changed policies multiple times in the past 3-4 years. Let’s dial it back a few years to understand how that affects your treatment session.

     

  • Prior to April 1, 2019, for a single physiotherapy session, clinics were paid $45 by ICBC. The private physiotherapy rate at the time was slightly higher, anywhere between $55-$75 per session. What that meant was you, the patient was responsible for tallying the overall cost by paying $10-30 more out of pocket. But, once the claim was settled, ICBC would reimburse the user fees to you.

     

  • Another obstacle to treatment at the time was approval. With ALL parties Suing ALL parties involved in order to get more money, ICBC was unable to approve treatment sessions for those that needed them.

     

  • As of May 1, 2021, ICBC unveiled the Enhanced Accident Benefits plan. Under the new plan, they introduced the No fault policy. What that means is this; regardless of whose ‘fault’ it is, everyone involved is eligible to receive benefits as prescribed by the service provider.

     

  • When you have received a claim number you can walk into any physio clinic and access treatment to recover at the earliest. ICBC has pre-authorized 25 physiotherapy sessions or 12 weeks of intervention for physiotherapy without any note or referral. The goal was to maximize intervention in the early access period.

     

  • In 2021, the payment structure changed too. ICBC increased physiotherapy coverage from $45 to $84 per session in an attempt to decrease user fees and reimbursements. However, most physiotherapy clinics continue to charge additional user fees which causes an unnecessary financial strain on you, the patient.

     

At Revere, we believe it’s unreasonable to ask you to pay out of pocket for your treatment when the accident was probably not your fault, to begin with.

Even though our private rates are higher, for all patients who have been in an accident we only charge the amount that ICBC covers. We believe this will significantly reduce your distress and enable your body to heal in an optimal environment. 

 

We offer evidence-based physiotherapy treatment at zero cost to you the patient as a gesture to support you in your recovery journey.

 

      2. Duration of a treatment session 
  • Knowing that clinics can reimburse a predetermined amount from ICBC, they are sometimes known to compromise on the duration of a session.

     

  • If you are being offered 15-minute sessions for your treatment, then we believe it is not the best practice. A physiotherapy session ranges from anywhere between 30-45 minutes when evidence-based protocols are followed.

     

At Revere, we are not stacking multiple patients at once or handing you over to an assistant. We are right there with you, for 30 minutes, through the entire process.

 

      3. Type of intervention offered 

Having worked in clinics around Vancouver, we believe the standards of physiotherapy care have dropped drastically. It’s important to remember that physiotherapy is allocated a significant amount of coverage in the enhanced benefits recovery package because Physiotherapists are experts in assessments and treatment interventions for injuries from accidents.

These injuries include: 

  • Neck strain 
  • Back strain 
  • Shoulder injuries etc.

In an effort to keep patient flow high, most clinics compromise on quality, sometimes choosing to hook patients up to machines as the only intervention offered. This attitude sadly goes against the reputation of the profession. 

 

At Revere, we offer one-to-one Manual therapy methods during which your physiotherapist provides ongoing feedback and assists you as indicated. The goal is to guide you to a pre-accident level of functional ability. 

 

       4. Interdisciplinary effort 
  • As physiotherapists, we are well-trained to assess your functional abilities and identify requirements for additional support. A thorough screening will give us valuable information on overall health. Additional support may look like an Occupational Therapy or Counselling referral.

     

  • Physiotherapists at Revere have been a part of multidisciplinary rehab teams and can provide education to you, the patient, on the benefits of seeking additional services if need be. We also communicate directly with your adjustors/case managers to make sure your treatment plan is good. We keep it simple and recovery-focused.

     

If you live in East Vancouver, Book now and drop into our clinic, we are open between 9 am and 6:30 pm, Monday through Saturday.  

If you have any questions or concerns reach out at info@reverephysio.com. We offer complimentary phone consultations for you to decide if we’ll be a good fit. Give us a call at 604-566-5108. 

Comment below and let us know of your experience while recovering from the accident-related injury. 

4 things to expect on your first Physiotherapy appointment

Be it a dentist, a doctor’s appointment or a physiotherapy appointment, there is just something about seeing a medical professional that can be slightly unsettling.  

Maybe this is your first time and you are not sure what to expect.  

Maybe you had physiotherapy before and because you haven’t seen much progress you want to switch clinics to try something different.  

If you’re someone for whom appointments with a medical professional are associated with apprehension, you are not alone.  

You could even be among the “I-don’t-overthink-it-I-just-wing-it” type of people and you just want some information. Talk about being in the right place at the right time, eh? 

Before we were service providers, we were recipients of physiotherapy services first hand so we get it. 

Information and/or reassurance, you’ll find both here, at Revere!  

Rates and Billing aside, this post is meant to break down all uncertainty about your first physio appointment.  

An average Physiotherapy session lasts between 30-45 minutes and is inclusive of the following 4 steps. 

 

The 4 step Physiotherapy process 

Now there are a lot different ways a physiotherapy session can go depending on the need of the client, but this is a general guideline on what to expect. 

 

An interview detailing your medical and relevant history
  • A physiotherapist will ask you questions and take a subjective history of your background. This is important information to shape our framework for the assessment. The more information we can get from you, the better!

     

  •  To give you an example, you will always be asked about the history of your injury: when it started, how it started, and what happened.

     

  • You will be asked about your social history: your job, hobbies, and activities which gives a greater understanding of the cause of the injury and its impact on day-to-day life.

     

  • You will also be asked about previous injuries and general medical health. The greatest predictor of future injury is past ones. This helps us categorize the issue at hand, for example, acute vs chronic, bone vs tissue, local vs systemic, and mobility vs stability.

     

Examination or Assessment 
  • An objective full-body assessment will then be the next step.

     

  • The quality/length of the assessment can vary in nature due to every therapist’s background and experience. 

     

  • Every therapist has their own specialties and education so don’t be afraid to visit more than one. This is why Revere Physiotherapist’s Team session is a useful option to explore.

     

  • A thorough assessment will not only help solve your injury in a quicker and more efficient manner, but it will also help prevent future injuries.

     

  • A quick example will help clarify; many clients come in with chronic low back pain, but there are over a dozen causes and factors that influence the rate of recovery. Focusing on assessing and treating only the low back, is a short-sighted approach to the condition and your symptoms. Assessing the neck, upper back, hips, and ankles provide valuable information on overall posture and athleticism.

     

Holistic care implies we look at the body as a whole to determine the best treatment strategy. 

 

Treatment
  • Treatment can come in many forms with the final goal to get you moving better and pain-free. 
     
  • The therapist may use their hands for manual therapy, mobilization, and manipulation techniques to reset soft tissue, joints and muscles.

     

  • The therapists may choose to use dry needling (IMS or acupuncture) and IASTR (Instrument assisted soft tissue release) to accomplish a similar goal such as in the case of more chronic/long-standing injuries.

     

  • Modalities such as ultrasound, laser, TENs, IFC are typically used in the acute stages of an injury to increase circulation and decrease inflammation. 

     

  • Your physiotherapist will determine one or more of these techniques as the most efficient option to release or reset the muscle/joint.  

     

An individualized exercise regime
  • The next step is to reinforce this manipulation through taping, stretching, or stabilization exercises.

     

  • Your therapist will want you to reload and retrain your body with the correct exercises so your body is moving better. This will usually come in the form of strengthening or motor control exercises.
     
  • The last thing you will do on your appointment is collaborated with your therapist on deciding the future course of action. You will most likely need a few more visits to recover completely.

     

  • It’s important to remember that this is a general framework and might vary depending on individual needs.

     

And voila! That is your first physiotherapy session. Congratulations on taking a big step towards better health and movement! 

That said, if you feel ready to begin your treatment book a session with us and we’ll take it from there, you’re in good hands! 

On the other hand, if you have any questions reach out to us. We are more than happy to alleviate your concerns and put you at ease.  

Visit our services page to learn about rates, billing and insurance coverage. 

In the meantime, if this post was informative do share it with friends who are putting off a much-needed physiotherapy session.  

How did you prepare for your first physio appointment? Let us know if there are any specific questions you have about the physiotherapy process that you would like us to address in our next post. 

Are you suffering from Post Covid Fatigue? Here’s how Physiotherapy can help.

Are you tired of being tired all the time? If you have experienced any form of Covid symptoms in the last year then you are not alone.

Data from the BC Centre for Disease Control and Prevention (BCCDC) suggests that almost 80% of BC population has been affected by Covid-19 or its variants, that number refers to the documented cases alone.

In this post-pandemic era, it has been quite nerve-wracking to read about Covid-19 and its variants. In addition to the threat of variants, provincial health authorities are urging the public to monitor for residual symptoms of Covid, also known as Post Covid or Long Covid, most easily camouflaged as plain old fatigue.

What is Long Covid?

  • While there is ongoing research to determine the definition and time parameters involving the post-Covid syndrome, Long Covid is best described as the post-acute sequelae of Covid-19. In other words, long Covid is what happens in your body when you are no longer infectious with the virus.

  • Research on the subject is mounting but long covid is not yet well established, i.e. risk factors, hospitalization, and treatment. What we know from existing research is that it can be extremely disabling causing activity limitations and social participation restrictions.

  • Long Covid can seem like a milder but extended form of Covid 19 that fluctuates in both severity and consistency causing severe distress to anyone experiencing it.

Symptoms:

  • Fatigue and brain fog are the most common symptoms identified. Among others are chest tightness, shortness of breath and dizziness. It can be accompanied by mental health challenges such as low mood, heightened anxiety and occasionally depressive episodes.

  • It is also evident that long covid impacts multiple body systems such as respiratory, cardiac, endocrine, and neurological systems.

  • Given the wide scope of long covid, rehabilitation is a key aspect of recovery. That’s where Physiotherapists, we come into the picture.

Physiotherapy role in Long Covid

     1. Establish a strong therapeutic relationship
  • Much like other conditions, physiotherapy in long covid is highly person-centered and goal-oriented.

  • We recognize the value in providing a safe space for you to share your concerns and your experience, especially since science is still in the process of catching up to lived patient experience.

  • We use patient-reported outcome measures to evaluate the efficacy of the rehabilitation program.

     2. Screen for Post-Exertional Symptom Exacerbation (PESE)
  • Before prescribing an exercise program, you will be screened for PESE. This means your symptoms will be monitored from absent to varying levels of physical activity.

  • Fatigue is the most common symptom, persistent fatigue that cannot be explained by any unusually difficult task. Most patients, in existing research, describe it as episodic and triggered sometimes by cognitive exertion or even mild physical tasks.

  • While treatment for fatigue is a graded exercise program, if not tailored to individual experience, it can cause further fatigue and therefore be rendered ineffective.

  • The screening for Post Exertional Symptom Exacerbation is obtained as a self-report. A brief 5-item questionnaire is used to elicit the most accurate result, based on which we determine the next steps.

     3. Screening for potential Cardiac impairment
  • This specifically applies to athletes and other high-intensity enthusiasts. If you are experiencing long Covid and are anticipating a return to the sport you will require medical imaging and tests to rule out cardiac conditions.

  • As we saw earlier, long covid can affect multiple systems, cardiac being a primary target. Regardless of whether you present with cardiac symptoms or not, if you are hoping to return to high-intensity activities this is an important step.

  • As physiotherapists, we understand that movement and return to recreational activities will contribute to health and well-being, but safety always comes first. We cannot begin your rehabilitation program until your physician has given you the all-clear with regard to your cardiac health. This rule applies to those of you returning to strenuous jobs as well.

     4. Pacing

In order to avoid Post Exertional Symptom Exacerbation, a physiotherapist will teach you Pacing as a self-management strategy. You are guided to less activity than you have energy for, keep activities short and rest often.

Pacing involves the following steps:

  • Learn about your energy reserve

  • Track your energy expenditure

  • 4 P’s- Priorities, Plan, Pace and Pleasure

  • Learn how to save energy

  • Learn to rest between activities

Your physiotherapist will also teach you to monitor your own heart rate with the goal of keeping it under 15 beats per minute to reduce the risk of PESE

      5. Manage Exertional oxygen desaturation
  • Your physiotherapist will actively monitor oxygen saturation using a pulse oximeter while introducing your graded exercise program. A mild drop in saturation is acceptable, anything beyond 4% can present with increased distress for you, the client.

  • All fluctuations will be recorded and exercises will be modified accordingly to ensure slow but safe and steady progress.

      6. Screening for Autonomic Dysfunction
  • With long covid, sometimes sudden changes in posture can lead to inconsistencies in heart rate and blood pressure. Keeping that in mind, it is most likely that your physiotherapist will ensure a thorough medical exam has been carried out with specific screening for orthostatic hypotension and heart rate differences.

In addition, as physiotherapists, we will provide you with an ongoing exercise prescription tailored to your individual needs while educating you to optimize recovery and regain function.

At Revere, we are here to address your rehabilitation concerns and curate an exercise program specifically for you. 

We are more than happy to answer all your questions. Give us a call at  604-566-5108

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Ancient Greece to Vancouver: Origin and Evolution of Physiotherapy 

Whether you are an undergrad considering a career in physiotherapy or a curious history medicine healthcare nerd or a client wondering how this wonderful profession came about, this one is for you.

How did Physiotherapy originate and where? To answer this question, we will have to dial it back. How many years, you ask? How about a few centuries?

Foundation for the physiotherapy profession can be traced back to the year 460 BC when Greek physicians like Hippocrates and Galen left an indelible mark on the healthcare sciences. Hippocrates was known to have introduced manual therapy, massage therapy and hydrotherapy to treat his patients.

In an attempt to regulate the practice, the Society of Trained Masseurs (STM) was formed in 1894 in Great Britain. For the first time, a biomechanical model of physical rehabilitation was proposed to view the body as a machine with different parts performing their duties accordingly. The focus at this time was only on massage therapy.

It was around this time that Orthopedics became an important branch within the medical field and along with it carried the role of physiotherapy to further advancement. Orthopedic surgeons operated on persons with disability. Following the surgery, they recruited women with specialized training in physical training and remedial practice.

In 1916, Polio became an endemic. Nurses began to use principles of movement and exercise extensively to treat patients.

The biggest surge in demand for physical training and rehabilitation came with the first World War, in 1918. Injured soldiers in need of rehabilitation and recovery were offered treatment by ‘Reconstruction Aids’- the very first physiotherapists. This brought about the institutionalization of the profession and the first Physical Treatment College was set up in Washington.

The first research paper in Physiotherapy was published in March 1921 in the United States.

The role of physiotherapy grew and with it, the number of practitioners. In 1948 physiotherapists from all over the world recognized the need for an international Organization to provide guidance and regulatory standards.

The World Confederation for Physical Therapists (WCPT) was born in 1951. It currently has 127 member organizations overlooking more than 600,000 physiotherapists worldwide.

History of Physiotherapy in Canada

  • The Canadian Physiotherapy Association (CPA) was established in 1920 and remains a founding member of the WCPT.
  • The pioneers of the profession were women who dedicated their lives to the service of injured soldiers returning from World War I. In the midst of pain and suffering, the profession has brought about much-needed hope and relief, as it continues to do today.
  • Physiotherapy is a well-respected profession as many Canadians who have benefitted from it will gladly endorse it.
  • The Canadian Physiotherapy Association celebrated its centenary anniversary in 2020!

History of Physiotherapy in Vancouver, British Columbia.

  • The Association of Physical Therapists and Massage Practitioners of British Columbia (APMP) was established in 1948 with two types of memberships offered: Chartered Physical Therapists- requiring supervision by a physician and Registered Physical Therapists– independent practice.
  • The College of Physical Therapists of British Columbia was formed in 1994, in Vancouver, and is the regulatory body for our profession even today. Physiotherapists no longer work under the supervision of a physician; we have evolved into autonomous practice.
  • Revisiting the history of a profession is vital to gaining perspective. As you can tell by now, physiotherapy was a profession that began with the goal of restoring movement, relieving pain and changing lives.
  • Fast forward to today, in and around Vancouver, there are several factors that influence the quality of service provided within a physiotherapy session, including but not limited to, pricing, insurance coverage, and the experience of the therapist. Let’s look at each of these factors individually.

Pricing

Within the last decade, pricing has increased to keep up with the economy, I.e., from about $50 per session in 2015 to about $90 on average today.

Insurance

With almost a 100% increase in price, you would think insurance coverage would increase too. Sadly, that’s not the case, putting the onus on the client to pay the remaining amount. It is only reasonable that with affordability concerns, you the client, expect fewer sessions and quicker progress.

Physiotherapist’s quality of care

  • Given the circumstances, physiotherapists are forced to demonstrate increased productivity, I.e. diagnose, and treat within a said number of sessions. In an attempt to improve productivity, some clinicians resort to modality-based treatments, I.e., leave you with a heat pack or attached to machines. This goes against the core philosophy of our profession and drastically affects the quality of care.
  • A good physiotherapist is one who is constantly assessing, treating, providing feedback and demonstrating movement. These are the components of evidence-based care.
  • In this post-Covid era, it has become all too easy to lose sight of why we as a profession exist. It has become all too easy to put your, the client’s, health and well-being at the back seat and instead prioritize monetary gain.
  • At Revere, we pride ourselves on our mindfulness of this fact. We pride ourselves on our values and our promise to you, our clients. At Revere, we are all about Evidence-based practice and 100% patient satisfaction.

What we do differently:

  • Team Physiotherapy Sessions: If you don’t know what physiotherapist to choose, pick any! If you aren’t improving to your satisfaction, we can send another physiotherapist (on top of your current one) in during your next session with your consent for the same price, just so we have another pair of eyes to assess your movements. This will allow our team to collaborate at its finest and ensure you get the help you deserve. Don’t be afraid to ask! Our whole team of physiotherapists is only focused on getting you better and a team session is the best way to learn for everyone involved.
  • Satisfaction Guaranteed: Sometimes, you may not mesh with your therapist or our team. That is quite alright! Our policy is if we can’t help you on some level, then we will not take your money. This allows all of our team to be accountable and to be able to provide the best service possible.

Book an appointment with our expert physiotherapists who will guide your recovery process.

In the comments below tell us about your experience with physiotherapy in the lower mainland. We would love to hear your feedback to improve our services.

If you are a student considering a career in physiotherapy reach out to us at info@reverephysio.com with questions and/or concerns and we are more than happy to serve as mentors. Share this post with your friends who are in the same boat.

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