FAQ

• Do I need a referral?

No, you do not need a referral to see a physiotherapist. Physiotherapists are first line practitioners.

• Do I need to bring or wear anything in particular?

Bring any referral letter, reports, X-rays or scans that are relevant to your condition or injury with you. Wear or bring comfortable clothing if possible.

• How long does a treatment take?

45 minutes. A thorough initial assessment will normally take 45 minutes. If you have multiple areas requiring treatment, please let our reception staff know at the time of booking. Follow-up treatments will take approximately 45 minutes, but allow one hour. If you are a new patient please arrive five to ten minutes prior to your appointment to complete some basic paperwork.

• Are home visits possible?

Yes, home visits can be arranged under special circumstances. We recommend treatment at the practice though, as we can not provide a comprehensive service in the home environment.

• Can I make appointments via email or online?

Not online at the present. For quickest response please make an appointment telephonically on +27 (0)76 370 7913 or alternatively via WhatsApp.

• Do you submit to medical aid or do I need to pay for the visit immediately after?

This practice does not submit to medical aid for out-patient visits (patients seen at the practice or home visits). Payment is done immediately after treatment. You can submit your receipt with emailed statement to your medical aid for reimbursement directly to you from your medical aid. In-hospital patient treatments (patients seen at CareWell) will be submitted to your medical aid directly.

• Can I pay by card?

Yes. We accept Visa/Mastercard or cash.

• Do you treat Injury on Duty (IOD) and Road Accident Fund (RAF) injuries?

We do not treat IOD injuries. RAF treatments will need to be paid by yourself and claimed back from the fund by you.

• Do I only need to see a physiotherapist?

No, not necessarily. While physiotherapists are a part of a multidisciplinary team, they are exceptionally well trained in orthopaedic, musculo-skeletal and movement impairment diagnosis. The physiotherapist may refer you to specialists or to other team members pending a thorough assessment, and, of course, your response to treatment.

• Is dry needling the same as acupuncture?

No. Dry needling is the use of acupuncture needles for treating muscle pain. It is not the same as acupuncture per se, which is applied according to certain Chinese medicine principles. Physiotherapists claiming to perform acupuncture must be registered as acupuncturists or Chinese medicine practitioners. The concept of dry needling evolved from trigger point injection using a syringe (‘wet’ needle).The action of the needle itself was observed to have more effect on healing than the medication it administered, hence the “dry” needle. Dry needling is used to elicit a natural healing response from your body by increasing blood flow to specific muscle structures, and stimulating your body's many natural pain inhibition systems, thus also stimulating the secretion of natural pain inhibitors. Not all conditions require dry needling! The decision to offer this rests with the therapist and the patient, together they can make an informed decision to accept this approach or not.

• Do you do Dry needling?

Yes.

• What is Physiotherapy?

Physiotherapy helps restore movement and function when someone is affected by injury, illness or disability. Physiotherapists achieve this through movement and exercise, manual therapy, education and advice. Physiotherapists maintain health for people of all ages, helping patients to manage pain and prevent disease through proper assessment, diagnosis, treatment and proper management. Physiotherapy is a science- and degree-based healthcare profession which takes a ‘whole person’ approach to health and well-being, which includes the patient’s general lifestyle. You can benefit from physiotherapy at any time in your life. Physiotherapy can help with back pain , sudden injury, managing long-term medical conditions such as asthma, preparing women for childbirth and rehabilitation afterwards and preparing athletes or the public for a sporting event.

• If I go to my physiotherapist, do I have to do anything?

Patient compliance and active participation in rehabilitation are key factors that any health professional has to capitalise on. Ask if you don’t know what to do at home, or if you are unsure of exactly what you can do to contribute to your recovery. It is incredibly important to note that you have a key role to play in your recovery. Be an active participant and not a passive recipient!

• Can my spine be clicked back into position?

Clicking or popping of spinal joints does not mean that joints were ‘out of alignment’ are put back into alignment. For example, you can look at your hand, ‘click’ your knuckles, and look at it afterwards only to see that it appears 100% the same as before, while feeling looser. We refer to the clicking of joints as manipulation, and the sound that is generated is called ‘cavitation’. This sound is likely the result of gaseous pressure change in the joint, and involves a stretch of the capsule and ligaments with a feedback message into the adjacent muscles that can cause them to relax more – in effect, loosening the joint. Manipulation is not proven to be the only method of restoration of joint mobility. True malalignment is seen in scoliosis and is not correctable by manipulation. Note that clicking one’s own spine is not advisable! The physiotherapist, after mobilising or manipulating the spine and releasing the soft tissue (muscle and fascia), will give you exercises that will strengthen the weaker muscles and lengthen any shortened muscles. In this way your muscles will be able to provide a strong pillar of support during daily activities and sport.

• Do I have a slipped disc?

The disc is adhered to the adjacent two vertebrae and will not separate from the vertebrae even in severe injury such as car accidents. The disc can therefore not ‘slip’ out – this is just lay terminology. The lumbar discs are cushions between the vertebrae and assist in shock absorption and movement. A disc has an outer layer of cartilage (annulus), and a softer gel-like centre (nucleus). With ageing, trauma, overuse or misuse, small cracks can develop in the cartilage with the soft centre distorting the cartilage (like a ‘tyre bubble’) or even pushing through (like a ‘burst tyre’). Medical terms like herniation, prolapse or protrusion are used to describe the severity of the disc injury. This can cause swelling and inflammation resulting in pain, or push directly on nerve tissue causing local or limb (referred) pain. In the leg this referred pain is called ‘sciatica’. An MRI is the tool typically used to make the most accurate diagnosis as an X-ray only shows bone structure. Manipulation is typically avoided by physiotherapists in the presence of a disc injury. Thorough assessment and solid clinical reasoning will help the physiotherapist determine what approach is to be used.

• Do I have a pinched nerve?

Nerves are not 'pinched' but can become compressed due to disc problems (see preceding FAQ) or bony osteophytes (spurs) pressing on them. If that is the case, pain (in the typical distribution of that nerve), tingling, numbness or weakness may result. It is possible to have pain and NO weakness/numbness/tingling, or weakness/numbness/tingling and NO pain, or BOTH. This depends on where the nerve is compressed. By the way, pain in the leg does not necessarily mean you have sciatica – let your practitioner make that diagnosis! Weakness and numbness are considered to be far more serious than pain and require urgent attention!!

• What is a Mulligan Practitioner?

Brian Mulligan, New Zealand Physiotherapist, founded the Mulligan Concept on the premise of joint mobilisation with movement for pain relief and restoration of full ROM of all joints and the spine. A Certified Mulligan Practitioner is a qualified Physiotherapist who has completed all three Mulligan Concept courses and thereafter have passed the CMP exam. Certified Mulligan Practitioners globally are listed on www.bmulligan.com for easy reference.

What is the difference between Physiotherapy, Biokinetics, Chiropractic & Massage Therapy?

• Physiotherapy:

A Physiotherapist assesses, treats and manages a wide variety of injuries including ailments from the fields of orthopaedics, neurology, respiratory and thoracic, cardio-vascular, obstetrics, sports medicine, paediatrics, geriatrics, intensive care units and general rehabilitation. Other medical fields and community care also falls within the scope of physiotherapy.

An orthopaedic and sports physiotherapist is a degreed allied health practitioner skilled in orthopaedic and neuro-musculoskeletal diagnosis, treatment and management of the client/patient. Note that rehabilitation, manipulation and massage are in the scope of practice of the physiotherapist. However, physiotherapists vary in their skill set and approaches based on post-degree and/ or higher degree education. These practitioners are sanctioned by and required to be members of the HPSCA (Health Professional Council of South Africa) and the South African Society of Physiotherapy.

• Biokinetics:

A Biokineticist is an allied health practitioner specialised in the rehabilitative modality of exercise to treat people with a variety of sport and orthopaedic injuries. The modality of exercise therapy is based on scientific evidence and personalised exercise prescription which is used in the rehabilitation for people with chronic disease, sport injuries and diseases of lifestyle. Health promotion and the maintenance of physical abilities as well as specialised physical activity programme prescriptions are within the scope of Biokinetic practice. Being degreed individuals, they are educated in final phase rehabilitation and prescriptive exercise interventions. The scope of practice of biokinetics does not include the manual physiotherapeutic approaches of mobilisation, manipulation, dry needling and direct soft tissue release of the musculoskeletal system. These practitioners are sanctioned by and required to be members of the HPSCA (Health Professional Council of South Africa)

• Chiropractic::

A chiropractor is a degreed practitioner titled a Doctor of Chiropractic. Chiropractic involves adjustments of the subluxation complex of the spine. These adjustments, when appropriately applied, are very effective when administered by a skilled Chiropractor. They are not, however, a fix-all for all spinal pain or pathology. Some chiropractors administer treatment to areas beyond the spine and may employ modalities similar to those used in physiotherapy. These practitioners are governed by the Allied Health Professional Council and not the HPSCA (Health Professional Council of South Africa).

• Massage Therapy:

Massage is very useful for therapeutic or relaxation purposes. Massage therapy can take several different forms. Massage therapists are certified by their institute of learning, and are not in any way educated in diagnosis or rehabilitation.