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Can Physiotherapy be done online?

Read time: 7 minutes

 Please note: Our articles are not designed to replace medical advice. If you have an injury we highly recommend seeing a qualified health professional. To book an appointment with Tim, or one of The Online Physiotherapy team, please visit our Physio clinic page. We have specialists for each major area of the body, ensuring you receive the best treatment for your injury.

‘Can Physiotherapy be done online?’ 

You friends, are asking the right question. This is a legitimate and a much needed question, particularly as we embark on new territory and push through boundaries of tradition.

Common questions can include;

  • Does my Physiotherapist not need to touch me to understand what is wrong?

  • How can a diagnosis be reached without seeing me?

  • What about massage and evidence for manual techniques?

  • If it can be done online, is it actually going to be effective?

  • Would it not be better to see a Physio near me?

Below you will find answers to these, and more.

‘The Executive Summary’

💡The power of Physiotherapy is in the expert knowledge and experience of your therapist, not in the passive movements or massage done to you however nice it may feel, or tradition dictates.

A study of 29,000 people concluded that ‘engagement in exercises improves outcomes, over-and-above any manual treatment and face-to-face interaction.’

Finally, the rapid advancements of technology means we are able to increase convenience, and compliance, making rehab more fun, not to mention the long list of additional benefits that come with Online Physio!

Can Physiotherapy be done online? Executive Summary

For those wanting my story + a deeper dive!

My story

In working as a Physiotherapist for over a decade across the NHS, and private sector I have been left disheartened and disappointed. This is nothing personal, but simply clinical. Treatment intervention is too late, and/or wrongly focused.

Sadly, I’m not alone. Many other Physiotherapists have raised similar concerns.

Research tells us that early intervention and active rehabilitation are important, and online physio tackles this head on.

On leaving my Consultant Physiotherapy post in South Sudan in 2018 and then the UK in 2020, this epiphany hit me harder than ever. I quickly immersed myself with research, speaking with other clinicians and experts, reflecting on the epiphany had, and how wonderful this could be for many in the UK, and around the world! If our question at hand is ‘yes’, imagine that for a moment. Convenience around my schedule, accessing the best from wherever I am, lesser costs due to low overheads, no waiting lists… gosh, that would be awesome! 

In my opinion, there are 3 keys when it comes to answering this question:

1. Experience and Knowledge

My epiphany: That recovery is predominantly based upon the experience and knowledge of your Physiotherapist to gain an accurate diagnosis through precise questioning, research-based advice, prescribing an exercise programme and guiding the patient through this. This I knew well, but saw in a new light.

The clincher: It does not lie in the manual techniques performed, contrary to tradition.

 

From the experience and knowledge of your Physio they will be able to ask the right questions to have a good idea of your diagnosis. It’s then confimed, (ruling others out), by assessing posture, palpation/prodding, testing of muscle length and strength, special tests and asking you to complete a few physical tests. Naturally this lends itself perfectly to the online space. 

 

knowledge is power

This epiphany of experience and knowledge over manual therapy, was also paired with the fact that the majority of people coming to in-person Physio rely heavily on the need to be ‘touched’, or massaged to get better – believing it an essential part of their recovery. Ultimately using their Physio as a crutch for too long, or not letting go at all! I sadly believe Physios are implicit in compounding this mindset too, but that is a story for another time.

To make the mindset above worse, most do not follow the advice given, complete their rehab programme, or the few committed patients that do fully commit to it, aggravate their injuries through travel to/from the clinic.

physio clinic room

Online Physiotherapy takes the focus away from the Physio doing all the work.

Truth: People are EDUCATED, GUIDED and EMPOWERED to play a crucial part in their recovery.

We believe this is the secret sauce for seeing quicker results than in-person Physiotherapy.

And so. If it really is primarily down to experience and knowledge, then the question is raised, ‘why not access the very best specialists for your injury, rather than settle for the Physio that is nearest geographically to you?’ 

The reality is, that accessing leading Physiotherapists would normally involve both high costs and then travelling to their location, which all in all can be quite a stretch. Imagine accessing experts from where you are, and at a fraction of the cost due to their reduced overheads? A great question indeed!

2. Manual therapy and other physical treatment options.

The research into manual therapies and other devices is not strong, when compared with education and exercise rehab. Furthermore, the reality is that if they are effective, their results are often short-lasting, needing regular appointments to boost the effect. This is true, whether we are talking, massage, manipulations, ultrasoundacupuncture, or other treatments like these. There will need to be further blog posts to further delve into these as we cannot simply state this and leave it there, but the research is out there for you to read – with more references at the bottom of this blog.

Do not mis-hear me. I am not saying that manual techniques do not work at all, because for a small number of conditions, they are powerful in managing vs fully resolving conditions. These can include fibromyalgia, and severe spina bifida.

What I am saying, is that;

Truth: Science-based advice, and a rehab programme that focuses on the root cause of the issue almost always beats manual therapy alone.

The root cause of an issue is often the length, and strength of muscles, inflammation of joints, or overloading of a tendon. These can all be improved through expert advice and a bespoke rehab programme.

prescriped rehab programme

I see too often the ‘breeding ground’ for recovery is what is often overlooked or undermphasised to recovery. Patients can get disheartened (naturally!) when they do the rehab every other day, or even every day, and the condition does not change. This is due to an ineffective programme, or moreoften an unhealthy ‘breeding ground’. The ‘breeding ground’ means things that help, or aggravate the condition outside of the programme. For example, with acute achilles injuries, walking or running uphill/downhill, or with neck injuries, doing tasks with your head down – the list can go on.

Study journal

The largest study into Virtual Physiotherapy by Ascenti in 2020, comprised of 29,000 patients from the beginning of the Covid-19 pandemic, and it concluded that “engagement in exercises improves outcomes, over-and-above any manual treatment and face-to-face interaction”. It also highlighted the significant improvement in pain and function scores similar to face-to-face Physio. You can read more on that study here.

Now. I am not against face-to-face Physio all together as it has it’s place for chronic pain or complex issues. Plus, some people simply prefer it and we’re fine with that. We will not deny we love to see people too, but only when it’s a partnership rather than a dependency. It definitely takes two to tango! For others, the psychological aspect is actually very important to them and they’re happy to buy into that, even if unaware that recovery can take longer.

All that being said, the question at hand here is, ‘can Physiotherapy be done online?’ The answer so far in this blog is, ‘yes’. In the majority of injuries we achieve the same (if not faster) results online in comparison to face-to-face.

3. Technology

With the explosion of technology within the last decade, these rapid advances mean that Physiotherapy Online is becoming easier and easier year on year. At The Online Physiotherapy, being specialists in delivering Physiotherapy virtually, we are fast to harness the power of technology available to us. We stay in-the-know of tech developments that make the quality of delivery even better, and on various levels, enable us to give a more in-depth analysis and treatment than standard in-person care.

These factors below are all contributing to better and faster recovery with Online Physiotherapy;

  1. Internet advancements  

    Accessibility and speed of the internet is improving around the world day-by-day.

  2. Fully interactive exercise platforms

    We use an app software called TrackActive. It seriously increases compliance and ease of rehab for our patients. It includes;

    • A scoring tool – used to give your injury a number  based on specific questions.
    • Your interactive rehab programme – complete with videos, your tailored prescription of length of stretch, no. of reps/sets and guides you through your rehab programme seamlessly with a timer to help keep you focused.
    • A physio diary – here you can comment and mark down your symptom level etc – of which our Physiotherapists can see from their end.
    • A messaging app – here you can speak with your Physiotherapist.
      exercise software
      TrackActive Software
  3. Augmented Reality (AR)

    The potential for harnessing the power of AR within the next 12 months is an exciting prospect. This is not about escaping reality as one may be led to think, but adding to it. For example, using images, targets, etc. that make the rehab into a game. This brings in a  healthy level of competition, which in turn increases engagement and compliance. We are currently liaising with 2 different companies around implementing AR into our practice.

  4. Artificial Intelligence (AI)

    We use a very smart app called Reflex Health that assesses your shoulder joint in 5 minutes, giving you metrics of range of motion and suggested exercises to improve this.

    Our AI Partner - Reflex Health
    Our AI Partner – Reflex Health
  5. Cyber Security

    Advancements include blockchain, the cloud, AI, IoT and apps – read more here. Global investment into Cyber Security is increasing significantly year on year, and the spend in 2028 is predicted to be $366 billion

The Online Physiotherapist has itelf stringent security measures in-place to ensure data is kept confidential and highly secure. The telehealth provider we use, Cliniko, takes security very seriously and is a core part of what it does. It creates one-time encrypted links going through their highly secure servers where they have a team monitoring the situation 24/7/365. For more info, check their page here.

💡 In Conclusion

Yes, the vast majority of musculoskeletal conditions, sports injuries, and post-op rehab programmes are effectively treated with Online Physiotherapy. In fact, the results from virtual physiotherapy, can actually be better and faster (which is the story we are seeing). This is because the power of recovery is in the Physiotherapist’s knowledge and prior in-person experience. With no passive treatment options, Online Physiotherapy directs its focus on active based interventions, bringing people away from the ‘crutch mentality’. This focus is more closely aligned with scientific recommendations than a lot of traditional in-room Physiotherapy, which is often passive treatment on the bed. Research states that most injuries and conditions involving joints and soft tissue respond very well to the right exercise programme and expert advice.

I do also want to be very clear. There are some conditions we would say “you absolutely need to see a Physio in-person” –  For us, this has been ~2% of the client base we’ve seen. Most will be fine to book staight in, but if you think you may be in that ~2% we currently offer a free 15-minute screening call.

To close. With research strongly supporting exercise prescription and expert advice (compared to passive manual techniques) and then combining this with advancing technology, we are so pleased to see people from all over benefitting from the effectiveness of Online Physiotherapy! Plus making access to experts more convenient, accessible, reducing costs, eliminating travel time and effort, no long waiting lists…the list goes on! Love to hear what is, or would be your favourite benefit of Online Physiotherapy – as well as any other thoughts/questions of course!

If you have an injury book yourself in below to start your recovery!

References

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