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Physiotherapy vs Exercise Physiology

This is a common question that we get asked in clinic and is a very important one to ensure you are seeing the right health professional at your current stage of injury management. Physiotherapists and Exercise Physiologist’s are both university trained professionals over the minimum duration of 4 years. They will usually work similarly at end stages of your recovery but there are some significant differences to be aware of early on in management.

- Ability to Diagnose: Physiotherapists solely have the training to be able to diagnose your condition. This may be musculoskeletal, neurological, cardiovascular or respiratory in nature. This is imperative to know early on to ensure you are on the right treatment plan for your needs and you know how long the injury may take to recover. In this area of the consultation your physiotherapist will also screen for any “red flags” such as cancer or a fracture that may be presenting as your everyday muscle ache/pain. If needed this is where your physiotherapist will be working closely with your GP to refer yourself on to the right specialist. They also have the ability to refer yourself on for an x-ray, ultrasound or MRI if indicated.

- Manual Therapy (“hands on treatment”): Physiotherapists solely have the expertise to perform hands on techniques such as massage, mobilisations, manipulations and dry needling (with extra training). These modalities are mostly used early on in the recovery process to help decrease pain, swelling and improve range of motion in the affect area.

- Exercise prescription: This is the area of treatment where both the role of a physiotherapist and an EP becomes a little blurry. In most instances a physiotherapist will mainly work on acute management and getting you back to the physical condition you were at prior to your injury. This is really a physiotherapists bread and butter as they have the ability to regress and progress exercises in the acute stage of management at a high level. While an EP will traditionally start to treat a patient after the acute phase when they have already been diagnosed by a physiotherapist or other health professional. EP’s predominately work to bring you back to where you were prior to your injury and will then continue to work with you to surpass your previous capabilities. This may be through programming to improve your fitness/sporting performance or maybe through increasing your strength and muscle mass. It is important to note that a physiotherapist does have the ability to progress an exercise program to these high levels. It is however dependent on that physiotherapists training/development outside of their degree, with this being an EP’s primary method of treatment.

- Education & Advice: This is a key modality of treatment in both professions. With the education in the early stages of management being performed by a physiotherapist. With the education in the later stages of management and on-going management predominately provided by an EP. Both professions commonly use a holistic approach to treatment to ensure that all aspects of your life are taken into consideration not just your injury/condition.

So in a nutshell who should I see and when?
If the injury/condition has not yet been diagnosed and you are in the early stages of recovery you are best off seeing a physiotherapist first and going from there. If it is a chronic condition or you are in the later stages of your rehabilitation it may be beneficial to see an exercise physiologist. It is however important to note that in a large amount of physiotherapy clinics currently an exercise physiologist is employed on site, which makes this transfer of care between the two health professionals smooth and transparent.