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Therapy

What is Therapy?

Therapy is a very general term that is used quite often in the medical sciences. The word can be expanded into the term "therapeutics" which is really that segment of the medical sciences that deals with the treatment of disease.

One can place a word in front of the term therapy and then it becomes a much more descriptive term. For example, chemotherapy is that branch of medicine that deals with the treatment of those diseases pertaining to cancers. This combination of words will transform the general term to a more specific meaning. The bottom line is that "therapy" is a term used to describe the treatment that is intended to help alleviate the undesirable symptoms of a condition (provided they are reversible) to the point of being curative.

In Sports Medicine, the majority of the time, we as healthcare providers are trying to restore the Musculoskeletal System (bones, muscles, tendons, ligaments, joints, and cartilage) back to a completely healthy state. We deal with many more aspects of healing, but the greatest majority involves the musculoskeletal system.

For those who have suffered some form of injury, there are many team members that help effect this final return to good health. The key players are the physicians (the family doctor, the primary care sports medicine practitioner, the orthopaedic surgeon, the rheumatologist, the physiatrist, the neurosurgeon, and the plastic surgeon), the physiotherapists, the athletic therapists, the massage therapists, the chiropractors, the acupuncturists, the shiatsu therapists, the podiatrists, the kinesiologists, the personal trainers, the dietitians, the chiropodists, the orthotists, and more prominently in the 1990's are the osteopaths.

One can see that there are many important people involved in the successful rehabilitation of any one person, and the skill of each is critical from the time of making the initial diagnosis to the last therapy appointment.

The main professionals involved in the physical rehabilitation of a musculoskeletal (MSK) injury of patients (in Canada) are both the physiotherapists and the athletic therapists. The overall goal of both of these types of therapists are to return the patient to full health as soon as possible without risking reinjury by the premature return to his/her sport or workplace.

The following will help distinguish the difference between Athletic Therapists and Physiotherapists.

Athletic Therapists (A.T.'s) are specifically trained in a community college to receive a 2 year diploma with expertise in the treatment of sports injuries. There training offers them the skills to work both in a clinical setting as well in an acute/on field environment (at the hockey arena/football field, etc.). In order to identify those who have additional experience and knowledge in the treatment of sports injuries, these therapists will have successfully written their Certification exams which will be denoted by a (C=Certified). Those therapists who are certified have to log a certain minimum of hours in order to meet the criteria in order to write their certification exams. The A.T's are especially skilled at taping different joints for competitions and in dealing with the acute management of all sports injuries. Athletic Trainers in the United States are comparable to our A.T.'s in Canada.

Physiotherapists (P.T.'s) are generally trained in a university to receive a 4 year degree in physiotherapy. The P.T.'s training is much more medically based with a strong emphasis of injuries with a basis in Orthopaedics, Neurology/Neurosurgery, and Cardiovascular conditions. Many of the degenerative joint conditions are well looked after by the P.T.'s as they are specifically trained in these areas. As well, the attention paid to teaching the manual hands on skills required of a P.T. to help facilitate the motion of muscles and joints is critical. There are many levels of learning in the intricate world of physiotherapy, and each therapist takes it upon him/herself to acquire this additional knowledge and expertise. These different training levels can only be taken once a P.T. has logged a minimum number of clinical courses.

As one can see there are both similarities and differences between A.T.'s and P.T.'s. Regardless of who a patient sees for their musculoskeletal condition, both types of therapists will provide the same services in reference to the following . .

It is significant to note that the cost for physiotherapy is noticeably higher than it is for athletic therapy. As well, many insurance companies do not recognize athletic therapy as a stream of therapy and therefore will not reimburse the patient when the patient receives therapy privately (as athletic therapy is a much newer discipline than physiotherapy) from an A.T.. Most rehabilitation facilities offer OHIP covered therapy performed by the A.T.'s and all the physiotherapy is offered privately. Always ask your physician which is the most appropriate therapist for your condition. Not every condition is for both types of therapists.

There are five stages to any rehabilitation program and they are the following . . .

  1. The first stage always involves reducing the pain.
  2. The second stage involves improving the patients range of motion of a joint and flexibility of a muscle.
  3. The third stage focuses on more stretching and strengthening of the muscle injured and those surrounding it.
  4. The fourth stage involves working on more specific exercises that are used in his/her sport or work place.
  5. The fifth and final stage of rehabilitation is working on the patients cardiovascular fitness level so he/she is fully capable of returning to his/her sport/work place.

All five of these stages should be achieved before returning.

Hopefully, this summary of therapy and rehabilitation will give you a better understanding of what the therapeutic rehabilitation process is all about and the difference between the main providers of Athletic Therapists and Physiotherapists.



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