Areas of Practice of Physiotherapy

Learn about the different areas of practice in physiotherapy

The human body is a complex system made up of hundreds of bones and joints as well as miles of muscles and ligaments all working in balance. When accident or illness affects your body, your physiotherapist, a university-trained medical professional, can restore mobility.

Working closely with physicians, physiotherapists help people in hospitals and clinics. You'll also find physiotherapists in neighbourhood schools, public health units, home and long-term care programs and sports medicine clinics.

To find your nearest Body Specialist, use our Find a Physio search option.

Physiotherapists treat the whole body and with ongoing clinical research, physiotherapists continue to develop techniques to prevent and treat physical injury and disorder.

Practice Areas

An area of practice is the arena in which the physiotherapist focuses the majority of their practice.

Additional qualifications are post graduate degrees, diplomas, or certifications, which increase the physiotherapist’s knowledge and practical skill set within their chosen area of practice. Some qualifications may be acquired through a 1 day course, while others may take more than 1 year to acquire. To learn more about your physiotherapist's additional qualifications, and how it can help you get back to doing the activities that you love, please contact your physiotherapist.

Acupuncture

A physiotherapist certified to use acupuncture uses fine gauge, dry needles that are inserted into the body at specific points selected as determined by meridian and chi theory. It is used to relieve pain and treat various physical disorders within the scope of physical therapy practice.

* There are a variety of acupuncture credentials that may be earned. "A physiotherapist may only use acupuncture if he or she has successfully completed a program listed in the College Bylaws Schedule "Approved Acupuncture and Dry Needling Programs" including associated examinations. Practicing acupuncture techniques on patients is permitted only after the physical therapist has demonstrated competency through successful completion of the approved course and has sent proof of their educational qualifications to the College.*

* "Practice Standard." College of Physical Therapists of British Columbia. Accessed Dec. 3, 2014. http://cptbc.org/ 

Breast Health

Physiotherapy is a recommended choice of treatment to help reduce scar tissue or cording in the breast and arm pit areas that may develop following surgery and/or radiation treatment for breast cancer. Typical types of breast surgery include mastectomy, lumpectomy, or plastic surgery carried out for breast augmentation. Post-operative scar tissue and/or cording can result in unnecessary discomfort, limitation of arm movement, neck and upper back aches and altered posture. Physiotherapy treatment will often include manual therapy, massage, stretching, posture correction and individualized exercise. 

Cardiorespiratory (breathing/heart)

Cardiorespiratory physiotherapy can help individuals who suffer problems with their heart, lungs and circulatory system. Common conditions include COPD, asthma and heart attacks.

Chonic Pain

Physiotherapy for chronic pain conditions can help individuals who suffer an array of complex, persisting, long term, and reoccurring pain syndromes. Management aims to alleviate pain, improve well-being and benefit participation in life by use of a broad range of interventions.

Ergonomic's (workplace health)

Evaluation and resolution of postural problems and work-related injuries such as carpal tunnel syndrome, low back and neck pain.

Hand therapy

Hand therapy is the art and science of rehabilitation of the upper extremity, which includes the hand, wrist, elbow and shoulder girdle. Treatments may include manual therapy, exercise prescription, massage, acute wound care, custom splinting, and scar management.

Intramuscular stimulation (IMS)

Intramuscular stimulation (IMS) is a dry needling (no substance is injected) technique that uses acupuncture needles to treat neuropathic pain. Neuropathic pain is caused by irritation or pressure on the nerves which in turn causes muscles to become shortened and hypersensitive. This is the cause of many chronic pain conditions and recurring injuries. IMS is a form of acupuncture.

"Acupuncture refers to the use of fine gauge, dry needles that are inserted into the body at specific points selected as determined by meridian and chi theory. Dry needling refers to the use of fine gauge, dry needles that are inserted into the body at specific points based upon segmentally myofascial, trigger points theory. Dry needles are solid, thin needles that have no ability to inject or withdraw fluid."1

"The terms acupuncture, dry needling technique and use of dry needles can describe a variety of approaches. Physical therapists may use a classical, neuro-anatomical or intramuscular stimulation approach, or a combination of these approaches, to acupuncture and dry needling."2

A physiotherapist certified to use acupuncture uses fine gauge, dry needles that are inserted into the body at specific points selected as determined by meridian and chi theory. It is used to relieve pain and treat various physical disorders within the scope of physical therapy practice.

* There are a variety of acupuncture credentials that may be earned. "A physiotherapist may only use acupuncture if he or she has successfully completed a program listed in the College Bylaws Schedule "Approved Acupuncture and Dry Needling Programs" including associated examinations. Practicing acupuncture techniques on patients is permitted only after the physical therapist has demonstrated competency through successful completion of the approved course and has sent proof of their educational qualifications to the College."3

1, 2, 3 "Practice Standard." College of Physical Therapists of British Columbia. Accessed Dec. 3, 2014. http://cptbc.org/
Incontinence (urinary/bowel)

Urinary incontinence is the complaint of involuntary loss of urine. Bowel incontinence is the complaint of involuntary loss of stool, gas and/or mucus. Although there are many reasons for urinary or anal incontinence, often dysfunction in the pelvic floor muscles is a large part of the problem. Physiotherapists who treat the pelvic floor have the skills to assess and retrain the pelvic floor and related muscles so they function more effectively to prevent leaking. Education in good bladder and bowel habits can also help correct these problems.

Joint replacement rehabilitation

Physiotherapy can help restore joint range of motion, flexibility and strength after surgery to help improve quality of life and help people return to active living.

Lymphedema

Lymphedema is a condition that can occur following lymph node removal that is a necessary component of surgical treatment for breast and other types of cancers. It presents as a swelling in the arm or leg but can also affect the face, neck and chest areas too. Physiotherapy treatment often includes manual lymph drainage (a special type of massage), appropriate exercise, activity modification and compression bandaging. 

Manual therapy

Manual therapy is a physical treatment with a focus on using hands-on techniques, generally with the aim of restoring normal biomechanics, such as reducing the tightness of muscles and mobilizing stiff joints.

Mental health

Physiotherapy can improve physical health and wellness in people whose primary health needs are related to their emotional or mental well-being. Treatment may include individualized exercise programs, which can improve mood and enhance social participation, motivation strategies, and promotion of self-management. Physiotherapy has been shown to minimize or counteract the side-effects of some psychotropic medications.

Neurology

Neurological physiotherapy can help individuals who suffer problems originating from the nervous system, including the brain, the spinal cord and the peripheral nerves. Common conditions include strokes, traumatic brain injuries, spinal cord injuries, multiple sclerosis, cerebral palsy, dementia and Parkinson's.

Oncology

Physiotherapy can help people undergoing cancer treatment manage pain, maximize independence and improve quality of life. 

Orthopaedics

Physiotherapy treatment of injuries related to bones, muscles, ligaments and joints. Injuries such as fractures, strains and sprains may be treated with a variety of techniques including manual therapy and electrotherapy.

Paediatrics (children)

Physiotherapy treatment of children under 16 who have orthopaedic, neurological and respiratory conditions, developmental delays, burns, and conditions such as cerebral palsy, spina bifida, muscular dystrophy, and cystic fibrosis.

Pelvic floor

"Pelvic floor disorders occur when the "sling" or "hammock" that supports the pelvic organs becomes weak or damaged."1 Physiotherapy treatment may include "pelvic floor muscle exercises, biofeedback, ultrasound imaging, muscle balance and core stability exercises, behavioural changes involving diet and toileting patterns and the use of internal assistive devices (pessaries). Bowel, bladder and pelvic pain issues can be difficult topics for many people to discuss and for which to seek treatment. Physiotherapists are committed to sensitive practice where clients receive treatment in a confidential and respectful environment."2

1 "What is the pelvic floor?" University of Chicago Medicine. Accessed Dec. 3, 2014. www.uchospitals.edu.
2 "Your first visit." Dayan Physiotherapy and Pelvic Floor Clinic. Accessed Dec. 3, 2014. www.dayanphysio.com.
Hydrotherapy (pool therapy)

Physiotherapists design individual and specific exercise programs in the pool. The buoyancy effect of water promotes a safe rehabilitation setting and faster return to walking, daily activities or sports.

Research

Physiotherapists base their treatments on evidence-informed practice to provide the best treatment possible. Some physiotherapists dedicate their careers to collecting data, studying, and researching a wide variety of conditions and clinical interventions to help provide up-to-date knowledge in the field of rehabilitation. Research completed by physiotherapists must be approved by a university ethics board.

Seniors' health (gerontology)

Physiotherapy treatment of age-related conditions such as osteoporosis, osteoarthritis, heart disease, immobility and prevention of falls. Encompasses treatment for multiple conditions occuring at the same time and considers medication use.

Sports therapy

Physiotherapy treatment of sprains, strains and other athletic injuries using techniques such as manual therapy, sport specific exercise, taping, bracing, and therapeutic modalities. Sports physiotherapists can also reduce the risk of sports injuries through preventative and screening programs as well as help enhance sports performance such as bike fittings, and running assessments.

Women's health

Physiotherapists in Women's Health can provide information and treatment that includes, but is not limited to: "bone health, domestic violence, HIV and AIDS, pelvic floor dysfunction related to continence issues or sexual function, lymphedema, or cardiovascular disease issues that are particularly relevant to women" Women's Health Division CPA Website.

 

 

Wound care

Physiotherapists trained in wound care can assist in the healing of open wounds with proper wound management including debridement and electrical stimulation if appropriate, as well as dressing selection.