When it comes to health it could be said that individuals have three choices. Firstly, the over-used cliché of ‘no pain, no gain”. If it’s not regular fatigue/DOMS and lasts for longer than a few days or recurring pain from certain movement, the question to ask is this factually beneficial to your health. Secondly, do not change, peer pressure or that famous T.V trainer or popular magazine said this idea/concept is great, so you just persevere and continue to lack performance or recovery from that niggling issue. Thirdly, is to consult a Sports Therapist or a Physiotherapist with a special interest in sport. Seeking professional help and being treated as an individual so you may start to slowly progress, rebuild and enhance performance or health. This leads to an interesting dilemma for the layperson on who they should consult – a Sports Therapist or Physiotherapist.
A Sports Therapist is able to recognise and treat common musculo-skeletal injuries…
As part of the ongoing treatment they are able to set up a complete progressive and effective rehabilitation program, which may be an everyday issue such as walking or return to a given sport that the Sports Therapist has a good understanding of. If a client attends the clinic with lower back pain, rather than being asked to lay down and be generically treated with massage, the clinician will attain a history of current and pre-existing conditions, examine the soft tissue through palpation, static assessment such as postural assessment and or movement screening to identify the root cause of the back pain. The Sports Therapist will be able to ascertain whether it is age related or occupational related fascial thickening and/or muscle imbalance causing the lower back pain. Treatable conditions are, but not exclusively, joint injury or muscular injury, may it be the foot, recurring ankle issues or plantar fascia issues to localised pain in the shoulder. A physiotherapist has a wider scope within Orthopaedics, Musculo-skeletally and within sport or where the issue may be inter-related to specific medical issues or involving the neural structure such as whiplash or a lumbar disc herniation and presenting with loss of motor function or neurological such as pins and needles.
Treatment modalities available overlap as both professions use treatments tools such as:
- mobilisation of joints and soft tissue
- movement screening
- movement re-education
- exercise prescription.
This is not an exclusive list.
Scenario of a client presenting with a common issue to a Sports Therapist:
A client attends the clinic presenting with lateral thigh pain, close to the knee. A static assessment will be carried out to identify possible ITB syndrome, which will be confirmed by palpating the muscle structure that attaches to the IT Band. At this point treatment may include soft tissue manipulation of the identified muscle groups. However, a good therapist will not just treat the end result, which is what may be causing the pain. The Sports Therapist will ask the client to perform a functional movement screen to identify the root cause of why the IT band may be placed under stress. A popular screening tool is the “one-third knee bend test” which looks at several aspects of the lower limb in a dynamic sense. Once the dysfunctional muscle is identified, specific exercises will be prescribed from static to active motion to strengthen the identified muscle or muscle group.
The same scenario assessed by a Musculo-skletal/Sports Physiotherapist:
A subjective assessment will be carried out to ascertain the history and onset of the presenting injury/pain. Special questions asked identify the source of the pain typically. Movement and dynamic assessments to assess movement, screening to rule out neurology and referral from a more central cause, ruling out spine/pelvis, biomechanics above and below the knee. A typical test used by Physiotherapists is the Obers Test which indicates if it’s a positive ITB (ilio-tibial band syndrome) and if that structure is tight and restricted. A full knee assessment will also be performed to rule out knee joint pathology. Treatment would involve release through the pelvis, lower back, deep tissue techniques into the Glutes, TFL and ITB itself. If required referral for orthotics to address any over-pronation to overload medial deviation of the knee.
Returning to the original dilemma, who to see. With the above in mind the answer may be either. If the Sports Therapist feels you need to be seen by a Physiotherapist then you will be referred accordingly. The distinguishing factors are, that if the issue is pathological, mechanical involving a torn or damaged structure, multi-faceted, chronic or you have suspected neurological issue then seeking the help of a Physiotherapist is the recommended pathway. If it’s a musculoskeletal issue then you have a choice on who to see and that may depend on what the desired end result is. If it’s as the example given above and the ultimate goal is to return to running then it could be argued that a sports therapist is ideal.
Where a Sports Therapist comes into their own, is when constructing the Rehabilitation protocol, sport specific, encompassing core, symmetry, working on performance, technique, speed, agility, strength, power and flexibility to move you smoothly from injured to fully fit and returning to your chosen sport, fitter than before.