Physiotherapy vs Sports Therapy
Written by Chris Heywood
This is perhaps one of the most commonly asked questions we get from our clients at Team Rehab uk so we though we had better write a short article on it. On the face of things it might seem like these two types of practitioner are similar, in fact some people even thing they are the same with a different title. The truth however is that they are really quite different but have an overlap, and it is this overlap that is most commonly seen by the public and causes most of the confusion. So let's try to clear this up a bit.
Firstly, for any of my professional colleagues out there, I have done my best to give an honest overview of this subject. Unfortunately, as both physiotherapists and sports therapists often compete for similar patient markets they do not always represent the most collaborative of practitioners, however, they really are different enough to each excel in their areas of expertise. I did read a few external articles on this subject in order to tray and get a good rounded article but I found that most of them, regardless from which side of the fence they are written, are aimed solely at one up man ship, so I will try to stay as accurate as I can!!
Both physiotherapists and sports therapists undertake an honours degree, a physiotherapist in physiotherapy and a sports therapy in sports therapy. It is in this degree however that the first large divergence occurs.
Physiotherapy is a profession that mirrors a modern medical approach which is why almost all physiotherapists in the UK graduate into the NHS setting, and work within the NHS for at least part of their career. Because there are so many areas of medicine such as surgery, intensive care, obstetrics, neurology, rheumatology, respiratory, orthopaedics, etc etc, physiotherapists train to be capable of working in a wide range of clinical environments, often work along side other health professionals such as doctors, nurses and occupational therapists, but to name a few.
I myself studied and graduated in London and started my professional career on the outskirts on London, in Ilford. For the 1st year of my career I worked exclusively in general medicine and intensive care. This was primarily so I could then partake in the oncall Intensive Care rota to earn some extra cash, but that setting is a far cry form the area of musculoskeletal (muscle, joint bones, nerve) that I myself specialise in today. Many of my patients are surprised when they happen to find out the areas in which I have worked but this means I have a very broad spectrum of clinical experience to call upon, when I see patients in the outpatient setting.
Sports Therapists on the other hand spend their entire degree studying around musculoskeletal system, but never normally work within acute or chronic hospital settings. After graduation, they normally work independently, or in gym or sports club settings so only ever have the private sector to learn in, or experience from. It may be that I was never to keen on my on nutritional lecturer, so may not have had a 100% attendance rate, but I would argue that in my day, we undertook less training that todays sports therapists in relation to general fitness , nutrition and gym related rehabilitation. I did train 23 years ago however so time may have changed.
In private practice, a vast majority of physiotherapists that you will encounter will have already spent years honing their skills across a broad spectrum of specialities, finally choosing to sub-specialise in the musculoskeletal system (MSK outpatients) This is the area where the cross over and confusion starts.
I don't think I would be out of place suggesting that the quality of training for sports therapists can be very much more variable than that of a physiotherapist. This is due to the fact that every physiotherapist that practices in the UK must be chartered and to be this, you must be registered with both the Chartered Society of Physiotherapy as well as the Health Care and Professions Council. Both organisations have very strict rules for membership and as such the training must adhere to minimal levels. This is very much in keeping with other areas such as GP's, hospital doctors, psychiatrists etc etc.
Sports Therapists however do not have to be a member of an affiliated body and do not have the ability to gain chartered status. This means that although some institutions do train to a level of musculoskeletal medicine pretty much equivalent to that of a physiotherapist, there are also many that do not. I have met quite a few final year, and post grad sports therapists, either for work experience, or as patients, and to be blunt, apart from two, their knowledge was simply not good enough to be working in private practice. I personally feel that if people are parting with their hard earned money for treatment they deserve to be getting an expert opinion.
Now to keep the debate fair, firstly, it would be remiss of me to not state that the same can be said for post grad physiotherapists knowledge as well. Without doubt, there are some that I would not let near my mother in law, never mind my dog or beloved one's (sorry Heather) but because it is rare for them to move in to private practice immediately, the knowledge and experience deficit is not so acute.
Secondly, as I like to see my self as a very fair, non profession bashing physio, such is my history and links with non physio practitioners, I must highlight an sadly obvious truth. ALL professions can have good and bad eggs and the physiotherapy and sports therapy environments are no different. At Team Rehab uk our youngest and most recent physiotherapists is in fact me; aged a young (ish) 44 years old with 23 year post grad experience. We are picky for a very good reason.
So what do I suggest you do? Well given the not so surprising bombshell that I have just fired, the first port of call on your agenda should be to get recommendations from friends, colleagues and family members. This is no different from finding a plumber, car mechanic or builder. If you are seeing a medical consultant then ask for their opinion, they will generally know who are good and bad in the local area. GP's can sometimes be a bit more reserved in recommending private clinicians so you will need to ask on an individual basis to test the water!
I would suggest that for every day muscle pulls, tears, simple joint pains, massage and soft tissue techniques, both physiotherapists and sports therapists will be able to look after you just as well as each other.
For spinal pain/disorders (low back, neck etc) or spine related nerve pain (sciatica, pins and needles, limb numbness etc), complex joint issues, post surgical rehab, hydrotherapy, women's health and chronic pains, but to name a few, I would definitely seek out a physiotherapist first. This is simply because as we are trained so much more in these areas and are less likely to tell you your SIJ is stiff, you have piriformis syndrome, or, my particular favourite being, you have the hamstrings of a 70 year old....
In my experience, physiotherapists tend to have more knowledge and expertise in spinal pain and at the front end of the clinical journey in hospitals and surgical rehabilitation. The middle ground of assessment, diagnosis and treatment of other MSK related presentations is largely separated only by the skills and knowledge of the individual practitioners, regardless of their profession. The sports therapists may have more skills when it comes to reintegration into sports and gym settings, depending on their experience, but this is not always the case if physiotherapists have subspecialised in this area. The physiotherapists then tend to have more knowledge at the back end of the clinical journey when it comes to chronic pains.
If you are seeking treatment via a private health insurance such as AXA, Bupa etc, you will need to see a physiotherapist (also one that is registered with the company in question) as sports therapists are not recognised by them.
For those of you with post stroke, brain injury, or neurological conditions, for example Cerebral Palsy, you should seek out a specialist Neurological Physiotherapist. Theses are practitioners that specialised in neurological rehabilitation and are quite different from the musculoskeletal physiotherapists.
Do I Need To Check my Practitioners Credentials?
I am always amazed when I get clients in for second opinions who tell me they have been having physio with Mr xxxx, and I tell them that they are not a physio. The general response is oh, are they not, well what are they them?
To be honest, I think this is where much of the frustration that physiotherapists have developed with the sports therapy profession comes from. Time and time we find sports therapy clinics offering 'physiotherapy assessments' or 'physiotherapy treatment' or may even have reference to 'physiotherapy' in the company title, despite there being no physiotherapists employed there!
This is in fact completely illegal as the term physiotherapy, physiotherapist, physical therapy and physical therapist were all protected throughout the uk back in 2005. This was to allow a clear distinction between chartered physiotherapists and other types of practitioner. In a court of law it is the same as someone who was not a doctor of medicine saying that they were! some may not be so brazen as to use these titles but will infer in every other way they they are a physiotherapist, and do not correct people when they enquire.
The majority of sports therapists would support me in encouraging you to report any clinics or practitioners that do this, to the HCPC, so that they can be investigated. This is because most good sports therapists are proud to be part of their profession and do a bloody good job of treating their patients and don't need to try and pretend to be something they are not. I am baffled by it.
Those that continue to do this only serve to put people at risk by deliberately misleading them and also give good sports therapists and chartered physiotherapists a bad name.
I am sure that despite my best efforts to discuss this topic fairly, I will still get some haters but alas, I have done my best to represent both professions as best as I am able.