Areas of Practice of Physiotherapy

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/ 

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

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.

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

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.

Physiotherapists use equine/horse movements to improve coordination, walking ability, balance and posture for people of all ages.

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/

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.

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 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 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.

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.

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.

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

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.

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 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.

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.

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.

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.

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.

Physiotherapists diagnose and treat problems, such as vertigo and severe balance disturbances, originating from the vestibular system.

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.

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.