Richard Watts / Times Colonist
August 27, 2014
Victoria’s Hana Kinsman never wanted to stop moving, despite osteoarthritis and two hip-replacement operations one after the other.
Kinsman, now 65, has always enjoyed skiing, cycling, swimming and once played a “vicious” game of tennis. So in 2010, recovering from one hip replacement and awaiting the next, she didn’t seem to be recovering as quickly as she wanted.
Nevertheless, when a friend recommended a physiotherapist she wasn’t optimistic. Prior to her surgery, while suffering from osteoarthritis, she had seen others and found little relief.
Happily, the physiotherapist recommended was Sandy Wilson, owner of Arbutus Physiotherapy and Health Centre, who specializes in treating sports injuries and athletes of all levels. So Wilson was well-equipped to help Kinsman reach beyond a mere comfortable recovery, to work a little harder and get back into an active lifestyle.
“She told me what I should do and what I shouldn’t do and there wasn’t much I shouldn’t do.” said Kinsman. “That was the opposite of the guidance I got from regular physiotherapists who work with the [older] age group of people who normally get hip replacements.”
Furthermore, the two women clicked. Kinsman was confident enough in Wilson to agree to the sometimes uncomfortable treatments and to follow advice about exercise. And Wilson, meanwhile, respected Kinsman’s desire to get back to an active life.
“I never say ‘Oh. you’ll never do that again or you should give up your sport,’” said Wilson, a competitive triathlete herself. “That’s their goal and that’s what we’re shooting for.”
“Even if they don’t ever get back to their sport I always believe it’s something worth shooting for,” she said.
Kinsman was lucky to find a physiotherapist, such as Wilson, whose expertise, approach and personality, were an excellent fit.
Rehabilitation after any surgery, or injury, can be critical to recovery. It can also mean weeks, even months, of regular visits. So it’s important to find a physiotherapist who is well equipped to deal with an individual’s needs. But finding the right physiotherapist can be confusing, since the profession is now at a time of seeming expansion and even fragmentation.
Patrick Jadan, a registered physiotherapist and Vancouver Island board director for the Physiotherapy Association of B.C., said it’s not that more physiotherapists are entering the field now.
But many are leaving hospital settings to enter private practice. This might explain what can seem like an increase in clinics popping up.
“The total number of therapists hasn’t changed that much,” Jadan said in a telephone interview from his Cobble Hill practice, South Cowichan Physiotherapy. “But the number who are going into private practice is certainly increasing.”
Once in private clinics, physiotherapists specialize in niche areas. It’s now fairly common for physiotherapy clinics to offer special techniques and methods, such as acupuncture, Pilates and chiropractic specialties such as spinal manipulation.
“Private practice environment just allows you to be more independent in what you can or cannot do as opposed to responding to physicians’ orders,” said Jadan.”
“There has been a large proliferation of physiotherapists expanding their scope of practice.”
This can make it seem more confusing when it comes time to select a physiotherapist. So Jadan recommends doing a little bit of research and some planning.
Most clinics will have a website listing short biographies and areas of specialty of their various therapists. So that’s a good start.
“If you have a sports injury you many want someone familiar with athletics,” said Jadan.
Also, if you are acting upon the recommendation or referral from a friend it’s quite accepted to phone a clinic and ask to be seen by a specific physiotherapist.
Jadan said such a referral from a friend or a family member is a great way to initiate the physiotherapist/ client relationship. The patient is starting with a little extra confidence and some advance notice of what to expect.
Therapists also can have letters after their name, such as FCAMPT. It stands for Fellow of the Canadian Academy of Manipulative Therapy, and indicates extensive amount of post-graduate education. Feel free to ask what the letters mean when you call.
Be aware and clear about what is bothering you, for example, what joint or body area is causing trouble. Then call ahead and describe your issue and ask to see the physiotherapists best equipped to help.
Also, explain what benefits you expect from a physiotherapy. A good therapist will offer some insight and provide some idea when improvements should start to appear.
Finally, physiotherapy can be close, hands-on treatment. It can ask for trust and commitment from the client as well as the therapist. So, if you and your therapist don’t hit it off, don’t feel bashful about seeking out another.
“Rapport is a huge aspect,” said Jadan. “You just have to wait and see how it goes.”
“Everybody’s personality is different,” he said. ‘You have to have trust and confidence in your therapist and if that is not there, for whatever reason, it’s probably not a good fit.”
Meanwhile, at Arbutus Physiotherapy, Kinsman believes she has found the physiotherapist she hopes to call on from time to time as she ages.
For now, with two hip replacements, Kinsman doesn’t just walk without assistance. She positively strides down the street, taking nice, big steps with arms swinging wide.
She cycles, swims and takes long walks regularly. Kinsman no longer plays tennis, however. But it was personal choice, opting to live with memories of her earlier intensity playing singles rather than switching to “ladies doubles.”
Nevertheless, she still skis and has taken up yoga, neither of which are recommended for people who have undergone hip replacements. Her doctor has become supportive seeing the progress Kinsman has made.
And she credits her progress to the assistance and advice she received from Wilson during their physiotherapy sessions.
“She let me do things and encouraged me to do things instead of telling me to be careful,” said Kinsman.
“Being an athlete herself she understood that if you have spent a lifetime being active you don’t want to spend the rest of your life limping around,” she said.
Some tips to choosing a physiotherapist:
• Choose the right practice for your needs. Call ahead and ask questions to determine if the physical therapists there can treat your particular condition.
• Consider how long it will take to get an initial appointment. If it’s longer than one or two weeks it might be best to go elsewhere,
• Look for a location close to home or to work. It shouldn’t be an ordeal to reach your treatment sessions.
• Inquire about the cost and the length of any particular session. One clinic may charge $60 but offer only 15 minutes treatment another may charge $75 but offer a half hour.
• Ask about cancellation policy and possible charges for a missed appointments.
• Specify if you wish to be treated by a man or a woman. In some cases it might be a religious proscription or it may be an issue of personal comfort. It’s your treatment and you should be at ease.
• Likewise, don’t be afraid to move to a new physiotherapist. Effective physiotherapy can be personal, hands-on and require at-home exercise in between appointments. Trust and rapport are essential.
• Visit the clinic, perhaps even arrange for a tour. Is it clean and well-maintained?
• Consider the atmosphere of the clinic. Are therapists and assistants standing around and patients sitting in a waiting area?
Sources: Hospital for Special Surgery, New York and Patrick Jadan, South Cowichan Physiotherapy.
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