We spoke online with Maciek Krolikowski to talk about the difference between kinesiology and physiotherapy, connecting with patients, and the move from the prairies to the west coast.
You got your Bachelors and Masters in Kinesiology at the University of Calgary, right? What was it like living and studying in Calgary?
It was good! It’s a big bustling city. The sports science part of the University of Calgary is top-notch, and it was great working there. The Sport Injury Prevention Research Centre there is recognized by the International Olympic Committee, so that means you get to work with international partners, as well as Hockey Calgary, and Hockey Canada. It’s fulfilling to see your work translating into real-world effects; some of the policy changes made by the team I was a part of got implemented by Hockey Calgary and Hockey Canada.
When did you come to Victoria? How has it been living here?
I came in about seven weeks ago! It’s been a huge change moving from a high altitude mountain-prairie area to living two minutes from the ocean; my partner and I are still getting used to living so close by the ocean and being able to go for walks and runs alongside it.
We love the city and the nature around it, and we love the people. Everyone’s super nice. Everything feels ten minutes away; it’s packed with a huge variety of shops, parks… there’s so much in such a small area, the city feels bigger than it actually is.
How did you happen to become a physiotherapist?
With my previous work in kinesiology, it was a lot of stats and research, but we also had a chance to work with thousands of hockey players and teams, and I really got drawn to the practical work side of things. I thought about working towards a Ph.D. in the future, but I’d rather have a clinical background before taking that on; I think it’s important to have both research and clinical experience, especially in physio.
What are some of the overlaps and differences between kinesiology and physiotherapy?
Kinesiology is more so the study of human movement; you get a more general understanding of everything in terms of people and how they move. You do research and nutrition, sports psychology, exercise, and so on. You become a good generalist in terms of how the body works and helping people move.
Physio is much more clinical; we diagnose and work with a variety of populations (cardiopulmonary, neurological, sport, and so on). It’s a lot more medical. Kinesiologists can’t diagnose a condition, but they can provide a clinical impression of a patient and prescribe and advance exercise programs to be part of the rehabilitation process. Physios are the ones who diagnose and prescribe programs and provide hands-on treatment for those conditions. As physios, we work closely with kinesiologists; they’re great assets and work closely with us in terms of advancing a person’s exercise therapy programs.
What’s your favorite thing about providing physiotherapy?
The biggest for me is connecting with patients and getting to know them as a whole person. Injury is not just physical, it’s bio-psycho-social; part of the work comes not just from treating the injury, but from connecting with a patient in terms of their understanding of the injury and what their goals are for recovery. You do the work and become part of their road to recovery.
Part of this is thinking about the psychological impacts of an injury, for example. If you think about your injury all the time, and you’re predisposed to anxiety or depression, your pain or injury might feel worse versus someone else with the exact same injury who might not happen to have those predispositions. A big thing we found in physio is that you, as a patient, seeing an x-ray of your shoulder does not necessarily express what you feel about your injury; there can be a disconnect between the injury itself and how the injury affects your life, and how you perceive the injury.
What would you say is most challenging in your work?
It actually is the thing I just said was my favourite! It is actually really hard to figure out and connect with a person, and for them to grow to trust you as a practitioner. It’s easy enough to figure out how something in the body works and how it should be managed; it’s much harder to fit that into someone’s busy schedule — if they’re a parent of three, for example — or to teach it to someone who hasn’t moved their body in a certain way before.
For me, the fun part and the hard part go hand in hand — the fun part is when you begin to figure out that connection and things progress.
You speak three languages! Can you tell us more about the languages you speak?
Polish is my first language; I didn’t learn English until I was four or so. My family thought we’d move back to Poland at some point, but we didn’t.
Later, my parents asked me when I was five if I wanted to learn French — I didn’t really know what that entailed at that point — but I said yes, and they put me into a French immersion program. I graduated with a French high school diploma.
My French is more rusty at times, but I’m fluent in English and Polish.
Do you have a specific body part that you find most interesting?
It used to be ankles. They’re a lot of fun, as they’re an integral part of the lower kinetic chain. When you work on them, you eventually also begin working on the knee, upper legs, and hips after a while. You see how a tiny joint really impacts and is impacted by all the other joints.
Right now I really like working on shoulders. They adapt well to strength, for the most part; I find with the shoulder it’s an area where one’s perception of a shoulder injury often plays a bigger part in recovery than the actual injury itself. It’s fun to tease that puzzle of perception out.
What do you do to keep moving?
I had to stop sprinting because it took a heavy toll on my body. It also took up a lot of time in my life too. So I had a big gap in my life when I took track out of it, and I filled it with mountain exploring. I did a lot of rock and ice climbing, backcountry skiing and cross country skiing in places like Kananaskis.
Recently I’ve been doing long-distance running, which has been a big change from sprinting. My girlfriend and I are doing our first 10km races soon at RunVan, in fact! It’s been fun to do sport for leisure, because you enjoy doing it, versus doing it for competition and focusing your whole life around it.
Do you see a lot of runners?
I’ve been interested in running gait analysis and using it to prevent and treat running-related injuries in all sorts of runners using a more holistic approach. Running can be impacted by a multitude of variables – be it a biomechanical issue, breathing, pacing, overuse, or a combination of them all. I draw not only on physiotherapy principles but my own experiences as a competitive runner in trying to work with the patient on how best to work with mitigating an injury and making their running more efficient.
In-clinic running analysis is a great tool as sometimes it’s difficult to see what can cause the dysfunction without actually seeing the patient running, and we can use the information to better direct the treatment.
As someone who is/was an athlete, have you ever had any of your own sports injuries?
Quite a few, actually! When I was a sprinter, I had a chronically-pulled hamstring, which is common for sprinters to get. But with help from a physiotherapist and my coach, we managed to get around it. That process helped me learn a lot about the biomechanics of running, which has helped my own clinical reasoning for when I treat patients, especially runners.
I’ve also badly injured my ankle a couple of times, so I definitely know the journey of recovering from a heavy-duty sprain. Having that first-hand experience helps, I find, to build trust with patients, especially when you come to a stage that appears to be a downturn, where you feel you aren’t progressing. It helps to know that it can be a part of the journey.