8 and a half things that might happen in physio that you don’t expect to happen in physio!


So you’ve booked your first physiotherapy appointment and don’t know what to expect? Or you haven’t been in some time and have forgotten what to expect? You may have been encouraged to seek treatment by your doctor, mother, sister or . You may not have been to a physio in a long time and things have changed since you were advised to “rest” that back injury or “elevate” that ankle sprain. We are lucky that physio is an ever-evolving profession and what advice might have been given to you years ago may not be applicable today. Times (and the research!) have changed!

1. In most cases, you can see your physio without having to see a doctor/GP first.

Physiotherapists are considered primary healthcare providers so you are able to book directly with us without a referral. We encourage you to inform us of your doctor’s details so we can keep them informed about your treatment and progress. Through your treatment, we will always take a detailed history and refer on if we think your treatment will be best done in parallel with other health professionals. Note that if your treatment is in regards to MVA (motor-vehicle accident), Worker’s Compensation, DVA or Medicare/EPC, you’ll have to touch base with your GP prior to your first consult.

2. Try to seek help for pain/an injury straight away.

It’s human nature to wait and see if something will get better or improve. You may have your good days and your bad days, so will keep changing your mind about booking your appointment. Generally, with non-traumatic pain, something is “brewing” under the surface that needs attention and more often than not, the earlier it is assessed, the sooner it will take to sort. This will lead to a faster recovery and the elimination of any compensatory or bad habits you may have developed.

But I’ve heard that things just get better over time?!

Pain can lead to muscle inhibition, which leads to other muscles working harder. This can lead to a prolonged muscle imbalance, poor habits, compensatory behaviour and hence drastically increase the chance of re-occurrence of your injury! We know that physiotherapy treatment can prevent that pesky back pain from coming back 1.

3. After your first appointment, we generally see you the next day (or ASAP).

This is in order to maximise the benefit from treatment effects, to give you the best clinical outcomes and to keep you on track. Don’t be alarmed if we see you a few times per week for a couple of weeks before tapering out treatment, based on your diagnosis. For most diagnoses, seeing you a couple of times in the first week of treatment will have more benefit than seeing you twice over two consecutive weeks. This is so we’re not “starting from scratch” again. If the time between your first couple of/few sessions is too spaced out, this can lead to the development of poor habits, exercises performed incorrectly and confusion about what to do if you develop some side effects between treatments (discussed later). There may be a lot of information to take on board about your diagnosis, so, if we’re seeing you frequently early on, we can answer any questions you may have and keep you on the right trajectory.

But seeing my physio six times over two to three weeks is going to cost me a lot of money?!

If your physio can lay out an early diagnosis and treatment plan, then this will allow us to get you better as soon as possible, help you set realistic goals and help get you back to 100%. If treatment is delayed or spaced out, poor habits and treatment planning, as mentioned above, may lead to a delayed recovery and more time and money spent along the way.

Remember everyone has a different plan! No two necks are the same. Someone, if they’re on top of their preventative strength program and booked in as soon as possible, may need a couple of sessions of treatment, just to get back on track. Your physio will recommend the most optimal plan.

We will also always rebook you after your first consult, except if you live out of town (even then, we’ll check in on you to coach you back to 100%!)

In regards to costs, most private health insurers partly cover physio treatment. You may also be eligible for treatment under the Enhanced Primary Care GP Services on the Medicare Benefits Schedule (MBS). This enables GPs to plan and co-ordinate the healthcare of patients with chronic or terminal medical conditions, including patients with these conditions who require multi-disciplinary, team-based care from a GP and at least two other health or care providers. See your GP for more information.

4. You might experience a little bit of post treatment pain/discomfort, redness, bruising or skin irritation after treatment.
You might feel that the pain you came with heightens for one or two days after treatment, or you experience pain somewhere else in the body. You may also experience some minor redness or bruising. These symptoms can be normal, should all settle quickly and can be caused by the pressure of manual therapy, massage, dry needling and other modalities we may use for treatment.
In regards to skin irritation, we use natural, hypoallergenic products, oils and tapes where possible and provide alternatives when needed. If you find your skin is irritated, red, itchy or sore after a treatment, clean the area immediately with soap and water and remove any strapping tape immediately.
if you are concerned about any post treatment symptoms, please discuss your concerns with your treating physio.

5. Pain doesn’t correlate with tissue damage.

Often, acute injuries are associated with marked muscle spasm and inflammation. This is just your body’s way of protecting and healing your injury and your diagnosis is not as bad as you think. Research shows that in the absence of trauma, pain doesn’t necessarily signify tissue damage 2.

6. If you’re in a lot of pain, we don’t necessarily refer you for a scan straight away.

We have a common phrase we use in physio – “We treat the person not the scan”. Many imaging-based degenerative features are likely part of normal aging and unassociated with pain 3.
Your physio will not expose you to unnecessary radiation in the short term to obtain information which won’t affect your treatment, although, if we suspect that referring you for a scan will give you the best clinical outcomes and will prevent further damage, it is our duty of care to do so.

7. We work in three phases – symptom relief, getting you back to what you need to do functionally and most importantly, prevention!

Often, patients will see their physio, have a “bit” of treatment and come back if their flare up again. I mean, as much as we love seeing you, wouldn’t it be great to not have to come back to us?! We like to “seal the deal”, so as to teach you how to look after your injury so every December, you’re not coming back to us with that bad back from dancing all night in high heels at the office Christmas party!
If you find that you can’t lift your grandchild because of that sore shoulder, wouldn’t it be better than instead of just making it feel a bit better, we help you become strong, so you can pick her up, hold her and hold her for a long time without pain and weakness?

8. Rest is a thing of the past!

Rest used to be recommended for back pain. Gone are those days! Research shows that extended rest usually doesn’t help back pain 4. In fact, well-designed clinical trials suggest that an early return to normal activities, with some rest as needed, is better than staying home from work for an extended period. Everyone’s treatment plan is specific to the individual and, if a short period of rest is needed to optimise rehabilitation, your physio will be clear on the timelines for this.

8 and a ½. We might need some of your clothes off!

This is suggested as half a point because most of you already know this! We’ll also stress this is optional and none of our physio’s would ever make you feel uncomfortable during your appointment! For example, when experiencing a wrist or hand problem, you may have some muscle imbalance around the shoulder and neck. If we can have a good look at those body parts, we’ll be able to make a more accurate diagnosis and hence better clinical outcomes. If treatment such a massage or mobilisation is required in these areas, we’ll cover you appropriately in towels and make you feel comfortable from start to finish.

The point is stressed that everyone’s physiotherapy treatment is very different. Two people with the same diagnosis will have very different treatment and treatment plans whereas two people with completely different diagnoses may have similar treatment plans.

At South Perth Physiotherapy, we don’t want to give you physiotherapy “treatment”. We want to deliver the best physiotherapy “experience” possible. Your feedback is vital to allow us to better our services and word of mouth is the greatest gift you could give.

During your treatment journey, your physio will discuss our other services at the clinic which are often recommended for your “prevention” stage of rehabilitation. Check out our “Services” section on our website www.southperthphysio.com.au and don’t hesitate to call our front desk for further information.


1. https://bjsm.bmj.com/content/55/9/468
2. https://bjsm.bmj.com/content/55/2/75
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464797/
4. https://www.health.harvard.edu/pain/bed-rest-for-back-pain-a-little-bit-will-do-you

Written by Lauren May

Lauren is our Principal Physiotherapist and Director at South Perth Physiotherapy and has a passion for seeking feedback on why patients “drop out” of their physio journey or don’t respond well to treatment. Lauren enjoys treating those patients who have not responded to physiotherapy treatment in the past and works with her patients to decipher a plan to get them back on track. So, if physio hasn’t “worked” for you, you’ve “lost faith” in physio or you would like a second (or fifth!) opinion, book in to see Lauren or another one of our amazing physio’s today.

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