What’s the difference between physical therapy and physiotherapy?

Most physical therapists are not qualified to deal with stroke or cardiovascular rehab unless they pursue courses that crossover with physiotherapy

We’ve all been there: you’re cutting the grass and you do your back in. You’re trapped at your desk all day and your wrist has developed persistent pain. You turn your head awkwardly and your neck has been giving you trouble for weeks. Whether you’re one of our younger readers or at the age where musculoskeletal issues are becoming all too common, when an issue presents itself it can be tricky knowing where to go for help.

So what’s the difference between physical therapy and physiotherapy? And does it matter where you go?

What is physical therapy?

“Physical therapy is a holistic patient-centred approach to helping all aches and pains of a musculoskeletal nature of the body,” says Mike Weaving. The UK-born physical therapist runs a clinic in Harold’s Cross, Dublin, and at his home in Co Clare near Ennis. (“Tony Kelly country if you’re into the hurling,” he says.)

“Anyone that comes to a physical therapist in my opinion is anyone with any aches and pains – joint tissue, tendons issue, musculoskeletal issues that are causing aches and pains and they want to get fixed and get back to pain-free life and living life to the best they can.”

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Depending on the need, Weaving might perform mobilisations, massage therapy, myofascial releases, trigger point therapy, cupping or dry needling.

What is physiotherapy?

“A chartered physiotherapist is a university graduate with hospital-based training,” says Sinéad Geraghty, practising physiotherapist and director of communications for the Irish Society of Chartered Physiotherapists (ISCP). “We would have a minimum of 1,000 clinical or contact hours out in hospitals or primary care settings within the health service. That’s one of the key strengths around our training.”

Physiotherapists can treat musculoskeletal issues, such as back and neck pain; rehabilitation, with elderly patients for example; respiratory, such as working with patients on a ventilator in ICU; and palliative care, among other things.

“Physiotherapy is very broad in what we can do but our main aim is supporting people to improve their health and wellbeing,” she says. “That can go from people being sick, to people sitting at their computer screen and for a couple of days you have a little bit of a niggle.”

Physiotherapists predominantly work in the health service, she says, in all sorts of disciplines. There are also private practitioners who work predominantly with musculoskeletal issues.

What’s the difference between the two?

“In my opinion there’d be a massive overlap,” says Weaving. “All musculoskeletal injuries, physios and physical therapists can treat.”

“When we qualify in physical therapy,” says Weaving, “the degree we get doesn’t allow us to work in hospitals ... In the private practice setting a physical therapist has got to know their boundaries. If someone came to me and had a heart attack I wouldn’t take them on as a patient. They’d be sent off to a physio.”

Most physical therapists are not qualified to deal with stroke or cardiovascular rehab unless they pursue courses that crossover with physiotherapy.

Why choose physiotherapy?

“Qualification is really a big thing,” says Geraghty. “When I seek out any service I always look at what qualification and what standards there are. The readers themselves would know what’s normal for them. But when something is not normal for you, and let’s say it doesn’t settle down after a few days and is getting increasingly worse – usually pain and stiffness are the big things people would complain about – that’s usually when people start to seek out physiotherapy.”

Why choose physical therapy?

“I think it’s up to the patient’s choice to go to who they want to go to,” says Weaving. “When you have a musculoskeletal injury, to pick a physio or a physical therapist it’s 100 per cent up to the patient.”

Among other things Weaving completed a three-year applied science degree. He charges €50 per session across the board.

“When you hear you might need 10-12 sessions it’s wrong,” says Weaving. “Rule of thumb should be – in my opinion, for a decent physio – if you can’t fix someone or see improvement in three sessions that person needs a scan. A person that cares about the patient would look for further investigation [by a GP or an MRI scan].

“The main thing for me is getting people better. If you treat people like muppets, if you abuse your knowledge on someone that doesn’t have any that’s in pain, I think your business will fail fairly quickly but that is very common in the Irish market ... Both [a physical therapist and physiotherapist] should be patient-centred. Both should be looking at the patient first, not their own bank balance, not their own ego.”

Does it matter who I go to?

For most musculoskeletal issues the majority of physical therapists and physiotherapists should be trained to treat you. Both physiotherapists and physical therapists are admitted under the one Coru register, the register of physiotherapists. Its board maintains a register of the profession, which can be accessed online, and sets out a code of professional conduct and ethics for practitioners to adhere to.

“There are people obsessed with the word ‘chartered’ in this country,” says Weaving. “But we’re just registered physios and IAPT (Irish Association of Physical Therapists) members. We are all Coru registered.”

So long as your healthcare practitioner is properly registered and trained to help with your relevant issue it shouldn’t matter too much who you go to – though physiotherapists are qualified to do a whole lot more and recognise non-musculoskeletal issues that a physical therapist might not.