Physiotherapy is the treatment of injury, disease and disorders through physical methods — such as exercise, massage, manipulation and other treatments — over medication and surgery.

Choosing a career in physiotherapy can be incredibly rewarding. In your daily work, you are helping people who have been injured to recover from or adjust to their conditions and live more independently. A physiotherapist treats patients across a wide age range – from young children to the elderly.

Many people may believe that physiotherapists mainly work with back and sports-related injuries, but that's not always the case. Physiotherapists are highly trained health professionals who provide treatment for people suffering from physical problems arising from injury, disease, illness and ageing.

A physiotherapist's purpose is to improve a person's quality of life by using a variety of treatments to alleviate pain and restore function or, in the case of permanent injury or disease, to lessen the effects of any dysfunction.

How to become a physiotherapist

Australia requires that all physiotherapists be registered, and according to data released from the Physiotherapy Board of Australia, as at May 2012, there were 23,301 physiotherapists on the register.

These professionals work in a variety of environments including hospitals, community health centres, private practices, sports clubs, rehabilitation centres, schools, fitness centres and in the workplace.

They either work alone or with other health care providers to deliver a multi-directional approach to rehabilitation.

Career development opportunities

There are several opportunities to advance your career in physiotherapy. There are career pathways in the public health system, as well as opportunities in the Australian Defence Force. Some private practitioners are also expanding their practices to offer additional services, such as Pilates classes. There are also opportunities for cross-referrals with other practitioners.

Physiotherapists are now able to complete a course to become a credentialled diabetes educator, and there is also the future possibility that they will be able to prescribe some medications, particularly those for pain and breathing, however, this may take a number of years to occur. It is also possible that critical care physiotherapists will be using techniques such as lung ultrasound in the future.

Physiotherapists can also work online. The Australian Physiotherapy Association has recently been highlighting research around Internet delivered physiotherapy services based on a study that internet-delivered treatments are effective in managing chronic knee pain. 

The role of the physiotherapist

The role of a physiotherapist is varied and rarely are two days the same. A physiotherapist may have to assess the physical condition of a patient to diagnose problems and implement a treatment plan, or they could also be re-training patients to walk, or helping others to cope with crutches, walking frames, or wheelchairs.

Education is also an essential role in physiotherapy. Physiotherapists spend much time educating patients, their families, and the community to prevent injuries and to help people lead healthy lifestyles.

A physiotherapist may also plan and implement community fitness programmes. Finally, physiotherapists can also issue sick leave certificates should it be deemed necessary to do so.

During their career, physiotherapists treat all manner of people including children with cerebral palsy, premature babies, pregnant women, people undergoing rehabilitation, athletes, the elderly (to try and get them fitter), and those needing help following heart disease, strokes, or major surgery.

Key duties of a physiotherapist

Physiotherapists use a variety of techniques to treat patients who are affected by injuries caused by illness, disability or ageing.

Some of the responsibilities of a physiotherapist include:

• Diagnosing and treating various physical problems or conditions
• Developing treatment programs
• Conducting therapeutic physical exercise sessions
• Using specialist techniques to treat various injuries or ailments
• Collecting and analysing data
• Writing reports and case notes
• Liaising with other health professionals such as General Practitioners, Therapists and Nurses
• Educating and training patients and carers about exercise and movement
• Keeping up to date with the latest industry knowledge and treatments

Types of physiotherapy

Physiotherapy can be an effective treatment for a plethora of conditions, and the following treatments can help lessen the recovery time after a variety of surgeries.

Physiotherapists can specialise in several different areas, including sports medicine, children's health (paediatrics), and women's health, and within these parameters, there are three different areas of practice. These are:

• Musculoskeletal which is also called orthopaedic physiotherapy and is used to treat conditions such as sprains, back pain, arthritis, strains, incontinence, bursitis, posture problems, sport and workplace injuries, plus reduced mobility. Rehabilitation following surgery is also included within this category.
   
• Neurological. This is used to treat disorders of the nervous system, including strokes, spinal cord injuries, acquired brain injuries, multiple sclerosis and Parkinson's disease. It can also be used for rehabilitation following brain surgery.
   
• Cardiothoracic is the name given to the treatment of used asthma, chronic bronchitis, emphysema and other cardio-respiratory disorders.

Types of treatment in physiotherapy

Each individual's treatment is tailored to suit their specific requirements, and a physiotherapist will choose from a wide range of therapies, including:

• Manual therapies – These can include joint manipulation and mobilisation (which provides for spinal mobilisation), manual resistance training, and stretching.
   
• Exercise programmes – Such as muscle strengthening, posture re-training, cardiovascular stretching and training.
   
• Electrotherapy techniques – Consists of Transcutaneous Electrical Nerve Stimulation (TENS), laser therapy, diathermy, and ultrasound.

In many cases, an injury can be caused by other underlying factors. It could be that constant back pain is caused by repetitive work-related activities, bad posture, being overweight, or even adopting the wrong technique when playing a sport.

Accordingly, the physiotherapist not only treats the back pain but addresses the other factors too. This holistic approach aims to reduce the risk of the injury happening again.

Physiotherapists in Australia have trained in universities and are registered health professionals. A referral by a doctor is not a requirement to visit a physiotherapist, but medical doctors may recommend a course of physiotherapy to help treat an injury or condition.

The Australian Physiotherapy Association is the professional body governing this industry, and practitioners can be found via contact with this association.

What's it like to be a physiotherapist?

For Curtley Nelson, a physiologist from Queensland, his wish is for more people to understand what physiotherapy is and just how much it can benefit different facets of their lives.

“It’s not just about helping with a musculoskeletal injury, but thinking of abstract areas, like helping with your breathing or your cardio-respiratory system. Helping with development as children growing up and helping their development.”

Mr Nelson told HealthTimes that the most rewarding element of his work is being able to facilitate growth – from the growth of his patients to the growth of his students and colleagues.

“Most of all, I love facilitating my community, where I am helping my community grow. Being able to provide that advice and education for my community, and to allow them to get better health outcomes is something that I really, really enjoy. It makes me want to be a physio.”

Mr Nelson didn’t always want to be a physiotherapist – in fact, his pathway to qualifying took a number of turns.

“The start of my career was a bit of a different one to most people. When I look back on growing up, I didn't know what physiotherapy was.”

“It wasn't until my time in the military where I was exposed to physiotherapy. From there, I got some little insights through my own rehabilitation that was like, ‘oh, physiotherapy could be a really cool aspect in life’”.

“But that was not where it had cemented me. It was actually when I was discharged from the army and I was looking to join the police force, when I had my partner come to me and said, ‘why don't you think about something that is challenging? Not just physically, but mentally as well, and really push yourself?’”

“That's when I started to think a little bit more broadly in some other aspects of life and what I find enjoyable.”

Mr Nelson said that since becoming a physiotherapist, he’s found the most difficult part of his work to be managing expectations versus reality.

“Understanding what’s really going to happen in the real world, which affects positive patient outcomes, is probably the most challenging.”

“That can be to do with the health system that we have at the moment, where we don't have enough funding for all our patients who may not be able to afford to come into physiotherapy to see us at multiple times.”

“Or it's adapting to how we actually work with our patients. It's something that I really find challenging.”

“We're trying to give that expectation to our new physios too”, Mr Nelson said.

“I just came out of a teaching class just now, where we’re prepping some of our fourth year physiotherapy students to go out into the clinic.”

“Some of the big things that we just were talking about is that you have this beautiful plan which you learn over in that physiotherapy degree, and it looks great on paper, but you have to think – how is this relating to reality, and adapting and changing for your patient?”

Physiotherapist Tom Hol believes his career choice is a result of working with physiotherapists as a high-level student-athlete, which led to an admiration for the profession.

"I came to respect how they helped me and what they did. I did work experience during high school in physiotherapy."

Similar to Mr Nelson’s experience, physiotherapy wasn't Mr Hol's first vocation though, because following high school he pursued a passion for food and became a head chef at a premier restaurant.

"At 24, I decided I needed a new challenge and went back to my first love – physio! I studied at The Australian National University."

Mr Hol now owns two physiotherapy clinics and enjoys helping people recover and to recognise the capability of their body.

"I love helping people get better and realise the potential of their physical body when otherwise they have given up or thought certain things are no longer possible because they're 'getting old'.

"I once treated a lady who had a back injury and wasn't able to lie on her front as it was too painful. She was told to avoid the position …and was particularly annoyed because she couldn't sunbake on her stomach at the beach!

"We then began treatment, and she can now easily lie on her stomach and do back extensions. She sent me a picture of her and her family at the beach, with her lying on her stomach. Such a great feeling to know I could help her!

There are challenges to being in this profession though, explained Mr Hol, and realising that you can't fix everyone is one of them.

"It can be frustrating. You can always refer to a specialist or surgeon, but sometimes you can get stuck as surgeons can't always guarantee a good outcome or don't necessarily believe that the course of treatment will work."