# Physiotherapy... Any point?



## Tom B (28 Aug 2021)

So a few weeks ago I fell down a hole while walking the pavementcrapper and damaged what I think will be the peroneal tendons. seemed a pretty decent injury eliciting upper tier swearing. Foot and ankle was swollen and bruising appeared from the side of my calf to my toes.

It has gone down a lot now and I've been walking on it again. It's still a bit sore if poked or flexed.

So I've thought about physio on it. I've never had physiotherapy in my life. I contacted a physio and they said yes physio will help (course they would) and it's £50 for the first session then £40 after. 

So what's this physio stuff all about? Could I just find a YouTube video and stretch it about?


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## fossyant (28 Aug 2021)

It's worth it. Anyone worth their quals will quickly identify the issues. I would not have got back to work after breaking my spine without the physio, as once the bones had healed, the muscles were causing more issues and very painful.

I occasionally use the students at work, we get a session for £25.

Even they identify the tight muscles immediately.

You need a physio that is hands on and works the muscles, not one that sticks you on ultra sound (he was useless).


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## PK99 (28 Aug 2021)

Tom B said:


> So a few weeks ago I fell down a hole while walking the pavementcrapper and damaged what I think will be the peroneal tendons. seemed a pretty decent injury eliciting upper tier swearing. Foot and ankle was swollen and bruising appeared from the side of my calf to my toes.
> 
> It has gone down a lot now and I've been walking on it again. It's still a bit sore if poked or flexed.
> 
> ...




Wrong exercise + wrong Time = more damage
Right exercise + right time = More rapid recovery

Physio will diagnose and either treat or refer on to a specialist medic.

https://www.foothealthfacts.org/conditions/peroneal-tendon-injuries.

We as a family have used sports physios multiple times and have never regretted it.


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## vickster (28 Aug 2021)

https://www.nhs.uk/conditions/physiotherapy/

if you happen to have private health insurance through work, it should cover physio sessions as well as any onward specialist referrals


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## Tom B (28 Aug 2021)

It's perhaps a basic question... But what do they do? What should I expect?.


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## PaulSB (28 Aug 2021)

Tom B said:


> It's perhaps a basic question... But what do they do? What should I expect?.


Yes, it's worth it. In broad terms the damaged muscle will be identified. In my case I had very tight trapezius. The physio massaged this to release tension and provided daily exercises for me to use at home.

This was five years ago. I still do the daily stretching as part of my overall stretching plan.

It works.


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## vickster (28 Aug 2021)

Tom B said:


> It's perhaps a basic question... But what do they do? What should I expect?.


See the nhs link. Many private practices will have a website with a what we treat, how we treat, what to expect page.

Take history, Examination, Diagnosis, manual therapy, could include massage, acupuncture, therapeutic ultrasound, they’ll make you do some exercises and give you a programme to follow at home.

I‘ve been having physio for the past year for a damaged ankle and knee, both before and after surgery (needed ankle ligaments repaired, too damaged for time and physio alone).
Also some offer hydrotherapy, I find rehab in water incredibly helpful as I can work far harder with less pain than on land


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## PK99 (28 Aug 2021)

Tom B said:


> It's perhaps a basic question... But what do they do? What should I expect?.



In my experience:

NHS = Diagnose mainly from verbal history + send away with exercise sheets. Repeat fortnightly.
Success = cope with normal life

Private Sport Physio = hands-on diagnosis + hands-on manipulation/treatment + Therapy machines + supervised exercises + homework. Repeat as necessary maybe 2/week initially decreasing as improve.
Success = back to sport


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## vickster (28 Aug 2021)

I’ve rarely had as often as twice a week (other than after surgery for frozen shoulder), sometimes once, more often every 2 weeks, even 4 depending on post op protocol.

Must be diligent with prescribed exercises if want to make good progress

The rates you have been quoted are very reasonable


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## Sharky (28 Aug 2021)

Our local hospital, has a self-referral to their physiotherapy dept.
Only resulted in a telephone consultation and some exercises, but helped.


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## KnittyNorah (28 Aug 2021)

Tom B said:


> So I've thought about physio on it. I've never had physiotherapy in my life. I contacted a physio and they said yes physio will help (course they would) and it's £50 for the first session then £40 after.
> 
> So what's this physio stuff all about? Could I just find a YouTube video and stretch it about?



As a (long retired) health professional myself, I endorse everyone else's endorsement of a few good physio sessions. However, you need to know that it's not just the physio who 'does it' - you need to do _your _part in the job by following their instructions/recommendations/exercises, otherwise you are losing half of the benefit. 

What you will _never _get from a you tube video is a hands-on diagnosis and estimation of damage, and a professionally-qualified opinion of the best way to most effectively heal and return to normal function whatever specific, individual-to-you damage has been done. 
How do you actually _know _that a You-tube vid is giving the correct treatment for you - do you have the appropriate qualifications to decide that 'stretching it about' a bit is going to help, not harm? You don't - that is why you consult a physio. Did you attend A & E for X-rays after the event? Or your GP? Some areas have decent NHS self-referral physio clinics but many don't.


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## Drago (28 Aug 2021)

Helped my when my dop bolwed me over at high speed and hyper-extended my leg.

A physio a made a massive improvement to my sciatica, all but cured it.

So id say worth it.


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## KnittyNorah (28 Aug 2021)

I'll just add, that the sooner you seek the attention of the physio, the better the recovery is likely to be.


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## ColinJ (28 Aug 2021)

I was running down a dark country lane one winter evening and didn't spot a deep pothole. One foot planted on the edge of the hole and turned sideways by what felt like 90 degrees. By the time that I had limped home my foot, ankle, shin and calf were going scary shades of black, blue, red, purple and orange!

I can't tell you how physio helped because I didn't have any treatment. I just dosed myself up with paracetamol and tried to keep my weight off that leg as much as possible for a few months.

Result? My leg hurt for many _*years *_after that! I think it was nearly a decade before I could no longer tell which ankle I had damaged (see PS below...).

Given how painful my outcome was, my verdict is... _SEE A PHYSIO!_

PS Ah.. That might explain why one of my feet was hurting on the forum ride that I did last Monday. I couldn't figure out why one would hurt while the other was fine!


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## Cathryn (28 Aug 2021)

My husband and I have both worked with physios on big or small injuries (broken bones, sore hips) and they've been brilliant. They're not cheap but definitely worthwhile. You DO have to do the exercises though, you have to commit to do them or it's a total waste of money.


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## KnittyNorah (28 Aug 2021)

The other thing to mention, for those who are doubtful about getting a private physio, is that I have to say it's been my experience that a reputable one won't keep 'milking' you - if after seeing you a few times, they think you'll progress just as well alone with the exercises you've worked through under their supervision, they'll advise you of this and tell you to contact them for a review in 6 months time, or something on those lines. 
So none of it's 'wasted' money; it's all 'active' as it were.


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## fossyant (28 Aug 2021)

You may only need a few sessions. Main thing is to identify what you need to do to fix it.

Bear in mind you will struggle to get anything via the NHS as they are massively over worked and are stuck mainly making sure folk can leave hospital or care. You being able to run or cycle isn't what their remit is, unfortunately. 

They (NHS physio) couldn't do much for my back after my broken spine. I was given all the stretches but actually needed some intensive work on all the tight muscles. Believe it or not, about 10 private sessions sorted me over say 3 months, then I just had occasional sports massages. Not needed any help for about 3 years now.

Even if you go once to assess whats wrong. Your GP nor the internet can help.


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## fossyant (28 Aug 2021)

KnittyNorah said:


> The other thing to mention, for those who are doubtful about getting a private physio, is that I have to say it's been my experience that a reputable one won't keep 'milking' you - if after seeing you a few times, they think you'll progress just as well alone with the exercises you've worked through under their supervision, they'll advise you of this and tell you to contact them for a review in 6 months time, or something on those lines.
> So none of it's 'wasted' money; it's all 'active' as it were.



I think most are busy enough to keep people longer than needed.


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## KnittyNorah (28 Aug 2021)

fossyant said:


> I think most are busy enough to keep people longer than needed.


Yes, good ones have as many clients as they want/can manage. They don't need 'vanity' work.


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## ColinJ (28 Aug 2021)

fossyant said:


> I think most are busy enough to keep people longer than needed.


To _NOT _keep people longer than needed?


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## Tom B (28 Aug 2021)

Thanks for all the advice guys. I can see it's all crap and a waste of money.


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## Low Gear Guy (28 Aug 2021)

The physio helped with my frozen shoulder. The appointments were available in this town in the evening and not the general hospital in the middle of the day.


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## Punkawallah (28 Aug 2021)

Tom B said:


> Thanks for all the advice guys. I can see it's all crap and a waste of money.



Why is my ‘Spidey Sense’ tingling? :-)

Compare the cost of the physio to how long you have already spent in pain. Then book him/her.


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## slowmotion (28 Aug 2021)

I had an extremely painful prolapsed disc in my lower back a long time ago. The neurosurgeon at Charing Cross hospital was keen to get his knives out but I resisted. That really made him quite irate. I had already started a course of physiotherapy with the NHS at the same hospital (exercises, stretching on a traction bed, etc) and, after about two and a half months, they did a brilliant job. It's been fine ever since. Go to your GP and try and get yourself referred to the physios at the local hospital. In those days it was entirely free. I have no idea if that is still the case.


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## KnittyNorah (28 Aug 2021)

Tom B said:


> Thanks for all the advice guys. I can see it's all crap and a waste of money.


Huh? I hope that's just you being sarcastic ...


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## vickster (28 Aug 2021)

slowmotion said:


> I had an extremely painful prolapsed disc in my lower back a long time ago. The neurosurgeon at Charing Cross hospital was keen to get his knives out but I resisted. That really made him quite irate. I had already started a course of physiotherapy with the NHS at the same hospital (exercises, stretching on a traction bed, etc) and, after about two and a half months, they did a brilliant job. It's been fine ever since. Go to your GP and try and get yourself referred to the physios at the local hospital. In those days it was entirely free. I have no idea if that is still the case.


With Covid, I don’t think NHS physio are doing much in person outpatient consulting. Zoom, or phone, at least initially.

In my considerable recent experience over the last year , physio and orthopaedics are next to useless by phone at least before a proper hands on examination and diagnosis (I had one Zoom consult with ankle surgeon, I was sat in front of her a few days later as she needed to look at me and properly see and feel the joint…fortunately it was Bupa who paid for both apppintments)


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## Bonefish Blues (28 Aug 2021)

Tom B said:


> Thanks for all the advice guys. I can see it's all crap and a waste of money.


That's a strange response to your own thread, where people with real-world experiences have shared them and made wholly constructive comments recommending something that's highly likely to be of help to you.


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## slowmotion (28 Aug 2021)

vickster said:


> With Covid, I don’t think NHS physio are doing much in person outpatient consulting. Zoom, or phone, at least initially.
> 
> In my considerable recent experience over the last year , physio and orthopaedics are next to useless by phone at least before a proper hands on examination and diagnosis (I had one Zoom consult with ankle surgeon, I was sat in front of her a few days later as she needed to look at me and properly see and feel the joint…fortunately it was Bupa who paid for both apppintments)


In my case, telephone consultations would have been entirely useless. Besides, I don't have a traction bed to stretch my back. They had to physically bully and cajole me into doing quite painful exercises. They were for my own good, of course, so I didn't resent their bossiness. The only important thing was that they fixed my back. God bless them.


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## Tom B (28 Aug 2021)

KnittyNorah said:


> Huh? I hope that's just you being sarcastic ...




Yup obviously too far..

I'll be giving the physio a go. I'll see if the work insurance thing covers it before the open wallet surgery.

I didn't go to a&e, was going to go to the "hobble in centre" but it seemed better the day after, GP point plant to have anyone in spoiling their clean floor and simply advised if you're concerned in any way go to A&E. After 3 days I wasn't.

Two weeks on its much better tiny bit of swelling and soreness. Full movement is back and mild pain at limits of range.

When I am wearing propper over the able work or walking boots it's fine trainers and low shoes less so. The worst thing was a day in the office with low shoes on where the foot was hanging in a shoe that got painful.

Photos from first couple of days. Toes later went back*excuse the dodgy toes


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## KnittyNorah (28 Aug 2021)

Tom B said:


> Yup obviously too far..
> 
> I'll be giving the physio a go. I'll see if the work insurance thing covers it before the open wallet surgery.
> 
> ...



When - not if - you go to the physio (and make it soon, please) take those photos with you.


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## bikingdad90 (28 Aug 2021)

I had lower back pain that persisted throughout the day and went for an NHS referral through my GP.

My initial telephone consultations gave me some stretches and booked me in for blood tests which turned out to be negative. At my follow up consultation I requested to be seen in person rather than by phone and the NHS physios agreed. After my assessment in person they scrapped the initial exercises I was given as they were no good and instead gave me some other ones because my legs and calf muscles were the problem not my spine as first thought.

I go every 8-10 weeks and each session I make improvements and get given more complex exercises to complete.

It hasn’t cost me anything and I have been happy with the service apart from the hiccup at the start.


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## Craig the cyclist (30 Aug 2021)

Just a word of warning, don't ever marry one


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## Ian H (30 Aug 2021)

PK99 said:


> In my experience:
> 
> NHS = Diagnose mainly from verbal history + send away with exercise sheets. Repeat fortnightly.
> Success = cope with normal life
> ...


Exactly my experience. Years ago my back went. I'd already booked with my usual sports physio but, as my doctor got me a surpringly quick appointment with the NHS one, i decided to run with both. The difference in both outlook and treatment was eye-opening. NHS said it would be with me for life & I'd have to change the things I did. My physio said _we'll soon have you back to normal_. That was nearly 20yrs ago and not had a recurrence since.


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## kingrollo (7 Sep 2021)

It's all about finding a good one. That has experience with you're particular injury. NHS is moving very much to hands off - excercises and stretching.

A private physio, may do dry needling, accpuuncture, deep massage.

Let's be honest the sums of money aren't massive compared to what we spend on bikes and associated gizmos !!!!


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