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What is physiotherapy?

24 Sep 2013
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Sarah Key MVO has been a treating physiotherapist in Sydney since 1970. She went to the UK early in her career and started practice in the medical precinct in London on Harley Street. She had phenomenal success in London and is best known for treating the Royal Family. She has written several best-selling books on back pain and joint pain, sold worldwide. In 1987 Sarah opened her Key Physiotherapy Sydney Clinic, which has served countless satisfied clients over the years.

In this article for About Pain, Sarah explains how physiotherapy works and how it can benefit you.  She goes to the heart of the patient-therapist relationship, and what it is that makes it so unique.  She also discusses 'the power of touch' and other personal qualities in therapists themselves that make them unique ...  

Physiotherapy, or physical therapy, is probably the truest form of ministering, one person to another and the closest thing in modern medicine to “the laying on of hands.”  

By definition, it is the using of human physical 'touch' to render both prevention and cure to a patient.  

As I see it, the primary essence of physiotherapy is the careful and respectful physical handling of another’s ailing body, in an attempt to do good. You might think that this is a tall order, and I would have to agree – even more so in these modern times where machines and gadgetry reign supreme.  

On the face of it, it is a very direct and personal thing, yet central to the role of Physiotherapy. I’ve always been aware of the unique privilege of it and, to me, the precious clinical intimacy of it is what physiotherapy treatment is all about. The proclivity, both physically and mentally, to put one’s self forward to make a difference, simply by the use of one's own hands and own body. Wow! That’s quite something.  

Experienced hands  

And yet, as one who’s been in the field a long time and more latterly teaching (see Masterclasses on, I feel I frequently need to reaffirm the potency of human hand-to-flesh contact – to both experienced and new graduate physiotherapists. I feel they themselves fail to notice the effect of their touch, and have no respect for its value – when any patient will tell you they know, almost the instant they feel the contact, whether a therapist has got what it takes – or not.  

There’s a certain “knowingness” from experienced hands that comes closest to the healing power of touch, which I don’t think we should slink away from.  

There is an enormous – errr, I suppose the word is - power (though I feel myself shrink from using it) in human touch. Effective physiotherapy treatment is delivered from this power, no matter what we do – and the patient senses that.  

Something happens when a patient feels you touch their pain. It's quite profound and works on many levels, not least because they can stop struggling, looking, endlessly searching (“the must be somebody or something that can help me!”).  

Touching the pain also gives people a kind of inner vindication, a sort of internal 'thank goodness' that this particular inside gremlin has finally been routed and that at last they can relax.  

Modern-day healer  

At last they can let themselves go and – perhaps most important of all in this complex elixir called healing – feel a sense of hope and a confidence in the future; a sense that one day, perhaps not too far away, they will feel strong and whole again. A return to the true and proper them.  

Other people can have this indefinable essence too – such as masseuses, Bowen, Reiki and Alexander practitioners, even faith healers – and all physiotherapists need to remember that.  

But I believe, with our academic skills learned though our physiotherapy training, that if we lay our hearts (and minds – more critical!) open to this possibility within ourselves –we will find it there. And furthermore, we may then perchance, become more than a mere technician; we will be approaching the status of modern-day healer.  

I’m intensely interested in the science because I feel that Physiotherapy needs to underpin all that it does with a proper scientific rationale – otherwise you might as well fan with a straw hat! As much as possible, an evidence base must support physiotherapy treatment.  

But I also know, because I’m an old dog, that other less definable but no less potent factors also play a part in healing. In other words, in order be effective, you can’t rely on the science alone. You need the other magic stuff too, like touch.  

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About Pain does not provide medical advice, diagnosis or treatment