What Should Physiotherapy Look Like? A Balanced Approach to Rehabilitation

What Should Physiotherapy Look Like?

Over the past 8 years in my physiotherapy career, I've seen the profession evolve significantly. At Ryan Harris Physiotherapy, we’ve embraced these changes while challenging the traditional model of care.

Previously, physiotherapy heavily relied on manual therapies and electrophysical agents like ultrasound and heat. Today, there’s a shift towards predominantly exercise only care. While this approach benefits some patients, I believe the best outcomes come from a balanced combination of manual therapy and exercise-based treatments.

Balanced Approach to Physiotherapy

Physiotherapy's primary goal is to reduce pain while gradually building strength and resilience in the injured area to help patients return to their daily activities or sports. Manual therapies, such as massage and joint mobilisations, play a crucial role in the early stages of recovery by reducing muscle tension and providing immediate pain relief. When combined with gentle exercises, like mobility drills or low-load resistance work, this helps initiate the process of loading injured tissues safely, improving flexibility and enhancing tissue resilience.

As rehabilitation progresses and pain decreases, the focus transitions toward building strength and capacity in the affected area. This requires targeted exercises that are progressively more challenging, focusing on developing endurance, stability, and strength. Without this progression, patients risk reinjury or failing to reach their full potential. Progressive overload, where exercises are increased in intensity over time, ensures that the injured tissues adapt and grow stronger. Unfortunately, many rehab programs fail to include this crucial step, leaving patients underprepared for the demands of their activities or sports. A balanced approach ensures comprehensive recovery, addressing both immediate pain relief and long-term strength building.

Individualised Care and Progressive Overload

Every patient who comes to physiotherapy presents unique challenges. Early in my career, patients would sometimes ask if treating the same injury throughout the day felt repetitive. While it may seem that way, the real challenge—and reward—lies in crafting the best treatment plan for the person in front of me. Factors like individual goals, fitness levels, physical activities, and even time constraints vary greatly among patients, even if they have the same injury diagnosis. What works for one person may not be appropriate for another.

Take running injuries, for example—patella tendinopathy, or Runner’s Knee, affects different athletes in distinct ways. A sprinter, for instance, needs power and explosive strength, requiring more resistance training. On the other hand, a distance runner needs endurance-based rehab with exercises focused on stamina. When you add sports like AFL or soccer into the mix, the complexity grows, as these athletes require agility, the ability to change direction, jump, and land—all of which must be considered during rehabilitation.

Patient history is another critical factor. Previous injuries, particularly those that weren’t fully rehabilitated, can influence current injury patterns. I’ve experienced this personally. At age 16, I underwent surgery for painful bunions and a broken bone in my foot. Due to inadequate rehab, I’ve struggled with pushing off through my big toe ever since. This limited mobility later complicated my ACL rehab at age 26. My rehab journey taught me that addressing previous injuries, such as my foot issues, was essential to fully recovering from the knee injury. This demonstrates how interconnected the body is and how each patient’s unique history plays a crucial role in effective physiotherapy treatment.

The Importance of Progressive Overload in Rehabilitation

As recovery progresses, one of the most critical concepts in physiotherapy is progressive overload. This principle involves gradually increasing the intensity of exercises over time to help the body adapt and strengthen the injured area. It’s a crucial step in the rehabilitation process, ensuring that the tissues can safely handle greater loads and stress, which in turn reduces the risk of re-injury.

Incorporating progressive overload into treatment helps bridge the gap between recovery and long-term performance. After initial pain relief and flexibility restoration through manual therapy and light exercises, we shift the focus to strengthening the affected area. This could mean adding resistance, increasing repetitions, or incorporating more dynamic movements. Whether it’s progressing from bodyweight exercises to free weights or introducing more complex movement patterns, the goal is to push the body just enough to stimulate adaptation, without overloading it too quickly.

Without progressive overload, patients may face a plateau in their recovery, where the tissues are not sufficiently challenged and cannot reach the level of strength and resilience needed for full recovery. This step ensures that you’re not only recovering but also improving the overall function of the area, preparing it for the demands of daily life, sport, and any physical activity you enjoy.

Why Manual Therapy and Exercise Go Hand in Hand

While progressive overload and exercise-based treatments form the backbone of long-term recovery, it’s essential not to overlook the role of manual therapy. At Ryan Harris Physiotherapy, we believe in the balance between manual therapy and exercise to achieve the best outcomes. Early in recovery, manual techniques like massage, joint mobilisations, and soft tissue release help reduce pain, increase blood flow, and restore movement. These therapies provide immediate relief, allowing the body to better engage in the more challenging exercises that come later.

As rehabilitation progresses, the focus shifts towards exercise, but manual therapy continues to play a role, especially in areas of the body that remain tight or restricted. By using a combination of both, we ensure a smooth progression from pain relief to strength building, minimising the risk of setbacks and creating a more holistic approach to recovery

A Tailored Approach for Every Patient

At Ryan Harris Physiotherapy, we understand that no two patients are the same. Whether you’re recovering from an ACL injury, managing a running injury, or rehabilitating a general muscle strain, your physiotherapy plan is tailored to your specific needs. Our team takes the time to assess your injury, understand your goals, and design a treatment plan that’s not only effective but also practical for your lifestyle. We take into account factors like your sport, work, and any past injuries to create a comprehensive recovery strategy.

We work with you every step of the way, adjusting the intensity of your treatment to match your progress. If you're training for a marathon or preparing for a local football season, our goal is to get you back to peak performance without compromising safety. This approach has allowed us to help many local athletes, whether it’s in Chirnside Park, Croydon, Ringwood, or Mooroolbark, return stronger and more resilient than before.

The Road to Recovery and Peak Performance

Physiotherapy is not just about treating injuries—it’s about ensuring you can return to your best, whether that means playing sport, enjoying daily activities, or simply living without pain. By combining manual therapy, progressive overload, and individualised care, we ensure that every aspect of your rehabilitation is covered.

If you’re dealing with an injury or looking to improve your performance, get in touch with Ryan Harris Physiotherapy today. Our team is here to help you recover and perform at your best.

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