We are at a crossroads in our profession, we have seen huge progress in the professionalisation of musculoskeletal physiotherapy in regards to its recognition with the general public and the medical profession. We have Consultant physiotherapists, Advance practice physiotherapists in diagnostic clinics that can inject, order scans and list for surgery.
We have an unprecedented need for musculoskeletal services within our communities as public health messages encourage people to age, work and live well. These messages urge people to regularly participate in physical activity and movement. However, this is underpinned by the requirement for excellent musculoskeletal health. (1), (2)
Physical activity is important for musculoskeletal health and can be used as a preventative measure. However when these measures fail optimal rehabilitative interventions are necessary. This is where the problem arises because as a profession we have for too long neglected our core business …. EXERCISE REHABILITATION!
Someone still has to treat patients!
Exercise rehabilitation is a difficult business and it has been made more difficult by the rampant underfunding of this key commodity in public services in favour of cheap, quick fix strategies and a lack of training for early career physiotherapists. Resources and funding over the years have been redirected to triage services and diagnostics. Consequently, many senior physiotherapists that were very competent and capable delivering rehabilitation have swopped roles in favour of triage and first contact roles. This for most part has led to a significant de-skilling in their rehabilitation expertise and an inability to keep abreast of the latest trends because of time spent in diagnostic clinics. It has led to a massive gulf between optimal and effective physio rehabilitation for patients because we have seen a decline in physiotherapists specialising in rehabilitation.
The downside of this has been a lack of opportunity for entry level physiotherapists and physical therapists to receive training in the essence of rehabilitation, physical preparation and strength and conditioning principles (3). There has also been a lack of mentored practice bridging the gap between theory and practice.
Rehabilitation is a specialist skill set which must be honed and developed like all other skills. It is a combination of anatomy, biomechanics, physiology, training science, psychology and communication skills. We have set up integrated clinical strength and conditioning for early career physiotherapists and physical therapists to readdress the balance. We want to provide a practical resource to help the next generation of therapists learn and develop skills in physical rehabilitation for MSK practice.
Because while we need our colleagues to do the important work in triage clinics …. Someone still has to treat patients and be passionate about rehabilitation. You owe it to yourself and your patients to do it well!
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