Frequently Asked Questions
Here are some Physio FAQ – frequently asked questions that we encounter with our patients. Click on the question to reveal the answer.
General Physio FAQ
Physiotherapy is a science-based profession that involves the prevention, assessment and treatment of disorders of human movement due to physical disabilities, trauma or illness.
It helps patients relieve pain, improve muscle strength, joint range and mobility, increase exercise tolerance and improve respiratory function. It takes a whole-person approach to health and well-being, which includes the patient’s general lifestyle.
Physiotherapy is based on principles of medical science and it is not related to any specific “technique” is typically associated with some of the alternative medicine treatments.
Physiotherapy as a health professional field employs any medically proven technique that is effective and “documentation-based” i.e. verifiable results from research and tests.
Physiotherapy is an extremely wide field of practice. Singapore physiotherapists generally focus on a one or two of these fields below:
- Burns and Plastics Surgery Rehabilitation
- Cardio-respiratory Physiotherapy
- Chronic Pain Management
- Child Developmental Assessment/Therapy
- Care of the elderly
- Neurological Rehabilitation
- Head injury, stroke and neurological diseases
- Paediatrics, Child Developmental Assessment/Therapy
- Sports Physiotherapy
- Women’s Health
- Palliative Care
At Core Concepts, we focus on a narrow set of musculoskeletal-based practice fields such as
- Chronic Pain Management
- Neurological Rehabilitation
- Stroke and neurological diseases
- Paediatrics (Orthopaedics)
- Sports Physiotherapy
- Women’s Health
Yes. Specifically, Singapore physiotherapists are governed by the Allied Health Professionals Act.
Physiotherapists are required to be registered with the Allied Health Professionals Council to practice in Singapore.
Physiotherapy is generally a degree-based profession. In Australia and the UK, it is very extensive 4-year full-time bachelor degree programme, similar to an engineering degree.
In the United States, to practice as a physical therapist is today requires a Doctor of Physical Therapy.
There is a trend today to require an increasingly higher academic requirement to practice for new practitioners.
Australia for one is gradually moving to a Master’s requirement (following a bachelor’s degree in physiotherapy). This is a result of the amount of learning needed to be competent.
Complementary Alternative Medicine is any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using the scientific method.
Examples of alternative medicine include homeopathy, naturopathy and chiropractic.
Physiotherapy on the other hand is Evidence-based medicine (EBM) (also called evidence-based health care (EBHC) or evidence-based practise (EBP) to broaden its application from medicine to the allied health professions) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.
How is it different from massage? How is different from gym exercises? They also ‘cracked’ my neck.
This is perhaps the most confusing aspect of the profession when compared to some of the CAM like massage or tui-na. The simplest analogy is to think about traditional herbal medicine and modern pharmacology.
There is often something going for a specific traditional herbal medicine for a specific condition but can often also be hit-and-miss. In some cases, the patient would have recovered regardless of any treatment. The human body is designed to heal on its own after all.
Modern pharmacological study these cases to see if they work (empirically and not because of random chance) and if yes; to understand why it works, what it is that is working (active ingredient) and is specifically what situations they work best such a dosage and if there are any side-effects with or without other medication.
Physiotherapy is similar in the sense that it takes and distils down what works with Evidence-Based Medicine.
A general massage may seem to work but a physiotherapist may be more effective by focusing on very specific muscles (there are lots of them) and applying very specific techniques.
Sometimes the understanding of the underlying problem is not based on scientific evidence such as innate intelligence
Sometimes a general approach may be good enough. Other times, you may require a much more targeted approach to cross over a healing hurdle towards getting better.
Well the answer is of course, yes and obviously depends on the problem itself, but would you like to feel better after 2-3 weeks or drag your symptoms out over 6-8 weeks?
Expanding on the previous analogy whilst taking antibiotics you would not suggest taking the pill once a week only, instead of the recommended daily suggestion; you would follow the prescription that the doctor or pharmacist best advises for you.
Spreading sessions out on a weekly basis, especially during the initial phase can mean that any loosening of stiff joints, stretching of muscles achieved during the session of physiotherapy may be lost in 7 days of you doing the “incorrect activities” that caused your pain in the first instance.
This may mean that each week you return for physio potentially back at square one with slower and smaller progression. So more frequent sessions in a shorter period will allow the therapist to keep a close eye on your symptoms, activity and achieve faster progressions.
The frequency of sessions may be tail off as a person is closer to being discharged.
In addition, shorter sessions of physio (half-hourly) may be more useful than hourly sessions during the acute and inflamed stage of an injury in particular, as too much mobilising, stretching and strengthening of aggravated tissue may worsen symptoms, so gentle and often is often the better approach.
In most cases NO. It all depends on the type of injury and whether the problem is acute or chronic.
Let’s take the analogy of when a person is ill and requires antibiotics for an infection.
You would not just take one pill and expect to get better? You would be expected to complete the full course of antibiotics similarly physiotherapy to treat a musculoskeletal problem will entail more than just one session.
In the acute phase, initial treatment will focus on protective measures to reduce inflammation and scarring.
In chronic patients, the nature of chronicity will mean changes to posture, movement patterns, muscles, joints as well as anxiety levels. All these things will therefore take time to change.
In most cases, there will be a combination of both muscle and joint involvement. Muscles are tight, stressed, strained all describing the same phenomena.
Muscle can also be weak and therefore painful when exerted. In this instance, a person may benefit from strengthening and stretching exercises all of which will take a little time to achieve.
If the joint is the source of pain, it may be mal-aligned, stiff, bruised and in the worst-case scenario be sore due to a fracture.
Again it is the role of the physiotherapists to decide what he/she feels is the best treatment modality to reduce the joint abnormality and thus the patient’s symptoms.
However, one session of joint mobilising may not be enough or be too painful, if, for example, the joint has been stiff for a year.
Therefore more often than not several sessions are required to loosen and mobilise the joint effectively.
After the initial assessment, the physiotherapist should have a good idea about the prognosis of your condition and should be able to provide you with a rough estimate of how many sessions you will need and over what period.
Now, this is something which you may think, and in some instances, 90% is as best as you are going to get, as is the nature of some injuries.
Again drawing on the antibiotics analogy you would have to complete the full course of treatment for the full effect of treatment, you would not stop taking the antibiotics as soon as you think your feeling better if your GP/ Pharmacist has advised you to take the course of antibiotics for ten days.
Similarly in physiotherapy, if someone comes in for a quick fix, an example being a low back strain, your initial sessions will consist of reducing the symptoms and pain.
This will be mobilising the joint that is stiff, releasing the muscle spasms and inflammation, and this alone may require 2-3 sessions depending on its severity.
At this point, you may feel your back is pretty much better, however, your back has not been strengthened and is therefore at great risk of recurrent injuries.
You may also not have received all the information for normal movement; you may not be aware of what faulty movement actually caused your strain or not have had the chance to process it due to the previous pain.
This could mean you return to your normal day-day activities with a weaker back and continue to do the things that may be strain your back.
The problem with repeating this cycle is each time you strain your back, it produces scar tissue in the affected ligaments and muscles.
Scar tissue at its best will never be as strong or as tensile as muscle tissue and therefore will further compromise the integrity of the affected structures leading to an even greater risk of recurrent injuries.
Hence it makes more sense to reduce your initial symptoms, learn how to look after your back, discover what is straining your back and strengthen your core muscles with individually prescribed exercises.
Yes, you can. However, do let your massage therapist know so that he or she can avoid going full-on with the massage. Too intensive a massage will result in your muscles being too relaxed.
This effect muscle recruitment later during your event. You will experience a lack of power and slower firing of the muscles. A full deep sports massage is fine 48 hours before your event.
For pre-event massage, like an hour before the event is usually light and aims to limber up the muscles. Not relax it as in the usual sports massage sessions.
It is a prudent to wait several hours after the end of the race. See here for an explanation.
There are no hard and fast rules as too how often you should get a massage. It depends on the intensity of your training and the propensity for your muscles to tighten up.
High-level competitive athletes get massaged once a day to help them recover from an intense training session. Other athletes get a massage 1-2 times every week.
If the underlying cause of your injury is unknown, it is advisable to seek an opinion of a health professional like physiotherapist to first identify it. It is always possible for a massage to further aggravate your condition if massage is not the appropriate approach for relief.