Getting therapeutic hands-on experience

Teaching people to self-care is key to the work of physical therapists Hands-on experience: physical therapy training

NECK, SHOULDER and back pain. Pains in the hip, elbow or knee joints. Sprains and strains from team sports or fitness training. These are the principle types of pain that people attend a physical therapist with.

"We give an overall assessment of the problem and then give a hands-on treatment," says Elaine Mullins, a part-time physical therapist who also works as a part-time staff nurse in the intensive care unit of St James's Hospital, Dublin.

What distinguishes physical therapy from physiotherapy is the first question that people always ask, says Mullins.

"We treat similar conditions but the approach is different. With physiotherapy, the client is given a series of exercises to do to cure the problem but, for physical therapists, the main emphasis is on the deep massage and joint movement carried out by the therapist," explains Mullins, who is a member of the Irish Association of Physical Therapists (www.iapt.ie).

"We also educate people on self-care and good posture, getting them to check their work stations and other areas of their lives to help them prevent further injury," she adds.

According to Mullins, public awareness of physical therapy has increased in the last four or five years, principally due to the fact that health-insurance companies now include it in the therapies they offer cover for. Each session costs between €50-€65 for 45 to 60 minutes of treatment.

Physical therapist Sue Devine works two nights a week with the Dublin senior hurling team, treating muscle strains, ankle sprains, wrist and hand fractures and other injuries sustained at training sessions or during matches.

"I teach the players the importance of exercises and stretching muscles and keeping the pairs of muscles in balance for tightness, strength and flexibility," she explains.

Senior hurler Pádraig O'Driscoll (29) finds it very useful to have a physical therapist on site during training sessions. "I go to the physical therapist even if I don't have an injury. That way I can get things sorted out before they become bigger problems," he says.

"Then, if something becomes an issue during training, we can go to her afterwards to see whether it will need further treatment."

According to O'Driscoll, most hurling teams at club and county level now have physiotherapists or massage therapists available at matches and also sometimes at training sessions.

"It helps prevent injuries which means that you are not hindered or hampered by something when you are playing. The concept is very good and I see a reduction of injuries in people who are treated regularly," he says.

Devine says that building up a good client/therapist relationships is essential in physical therapy. "That way, people will trust you and understand that it is not beneficial to go against the advice you give them," she says.

This applies just as much to someone who needs extra recovery time from an injury before playing a match as it is does to an older people suffering from osteoarthritis who shouldn't push themselves too hard. "We teach people how to manage their own condition," she says.

Devine also stresses the importance of knowing the limits of your practice. "Physical therapists treat muscular skeletal pain and although we can treat some forms of referred pain, it's essential to refer on patients with nerve pain or pain that might be part of a disease process."

Physical therapy is also not an appropriate treatment for inflammatory conditions.

Generally speaking, physical therapists recommend four to six treatments. "If the person is not responding to treatment after two or three sessions, they may need another approach," says Mullins.

"Patients can often be really tired, sore and feel worse after the first treatment, but with successive treatments, they will feel better. We advise people to take it easy and drink plenty of water to flush out their system after the treatment."

The Institute of Physical Therapy (IPT) in Stillorgan, Co Dublin is the main training centre for physical therapists in Ireland. Since 1989, the IPT has trained physical therapists to diploma level and has recently been approved by the Higher Education and Training Awards Council (HETAC) to provide Ireland's first degree course in physical therapy.

This part-time course will result in physical therapists having a BSc in Applied Health Science. John O'Sullivan, director of the IPT, says: "We see this as a very significant development for the profession and for the area of manual or hands-on treatment. We expect the standard to quickly become the benchmark within the industry."

O'Sullivan also suggests that the degree course will offer "academic progression for the hundreds of students who complete holistic massage and sports massage courses around the country every year."

Log on to www.iptas.com