Bring up the topic of amateur football in a conversation and it always seems that, before long, it turns to talking about injuries. Everyone gets injured at some point, it’s just the risk you run when playing any sport.
At the very least it results in discomfort, and at worst it can keep us out of action for weeks, months, or even years. Avoiding injury is best, but what about when it’s already struck?
Most of us don’t have the medical knowledge to determine what the problem is – usually our default setting is just to hope that it heals with some rest. But is that really always the best approach?
It is worth seeing a Physio?
You can’t say it much more clearly than the way that one of our twitter followers put it when he was asked if he thought it was worth seeing one:
— Rosco (@McIntoshRosco) April 19, 2016
Logically, it makes sense to consult an expert when you’ve got an issue. If your car had broken down you’d take it to a mechanic, so why not consider taking your clapped-out body to a physio when it has been injured?
Most of us just don’t know when we should go and see a physio, what they could do for us, or whether they’re worth the money. So I went and saw one: Nell Mead, Clinical Director of Victory Health & Performance – based in London – for answers.
Nell was named the Best Physiotherapist for Serious Injuries and Rehabilitation by physio-finder website Zesty so she knows a thing or two about getting people back playing sport.
Why you should go and see somebody if your injury hasn’t started to heal within a week.
In some cases it’s very obvious that you need to see a medical professional right away to deal with your injury, especially where it’s serious. But what if it’s something like an Achilles injury that you might be able to shake off in a couple of weeks?
The problem is that injuries that take a longer time to heal can end up causing knock-on problems, leaving you with potential problems for the future.
Nell explains: “most injuries go away in a week or two, and I usually don’t end up seeing those. But if an injury goes on longer than that then you are going to start creating a dysfunction within your central nervous system. So your body will start to compensate for it and when your body starts compensating for it then that can lead to further complications.”
A ‘dysfunction in your central nervous system’ sounds a little technical, but Nell has a simple analogy that gets the point across: “imagine you have a fantastic football team (the 11-a-side variety) but the star striker gets injured and there are no subs, so the side is now down to 10 men. The team then get used to playing with 10 men. Now, after 6 months, the striker comes back from injury but the problem is that the rest of the team don’t know how to play with him anymore.”
“So, just as you’d need to gradually bring that player back into the team, you then have to reincorporate that previously-injured body part back into the body. The problem is, a lot of the time you have developed such different habits of movement as a result of the injury, and from compensating for that injury that you don’t really know how to do it. And then you have become vulnerable to other injuries.”
This is where a physio comes in. They can teach you better movement patterns so that you don’t pick up a load of new problems as you try and shake off your existing ones. The more you compensate for old injuries, the more you are vulnerable to new injuries.
But what about seeing a doctor – that will do the job, right?
As Nell puts it: “Doctors are fantastic people and are great at being a triage service to send you on to specialists, but in general they are not great at diagnosing musculoskeletal injury. They get some training in it, but most of them don’t get the opportunity to use this training well. So if you want a diagnosis, my suggestion would be to go to a physio first, and we can refer you on to further specialists if you need it.”
A doctor can still be very useful, and there are times where you should see one instead of a physio. That would be if you need an X-ray or other scan, or if you’ve got health insurance and you need a referral on to a physio (many require you to see a doctor before they will authorise physio treatment). If you want specialist musculoskeletal treatment and rehabilitation, however, a physio would be more experienced at dealing with the issue.
How much does physiotherapy cost?
If you’re a UK reader then you may be aware that you can get physio on the National Health Service (UK readers only) and that will be free. However, it’s not always specifically sports focussed (after all, physios exist to treat a variety of conditions). There are some good sports centres, but the majority of really good sports physiotherapy is private and needs to be paid for.
Physiotherapy can start at around £35 per half an hour (depending on your location – e.g. in central London you’re looking at much nearer a starting price of £50) and you can get some good treatment at this level.
Nell’s advice is to go beyond just looking for the very cheapest. Like a lot of things, you get what you pay for. “It’s not about just looking at the cost of it; look at the value you get from it. With a quality private physio, such as ourselves, they will not only treat the injury but they will give you support in between, send you videos of exercises, take videos of you doing exercises, respond to any email queries that you have. It’s not just about coming in for an hour and then saying ‘see you in two weeks’”
A while ago I got a knee injury playing football. After the game I was in a lot of pain but I manfully (I like to think ‘heroically’) struggled on thinking it would just get better with time. After several weeks, it hadn’t cleared up and I was still walking with a bit of a limp. Then a strange thing happened, I started getting pain in my other knee even though I hadn’t played any more football. What could I have done differently if I had seen a physio?
Nell’s response: “First of all I would have assessed not just your knee but your whole body. The chances are, if you had a lot of pain, you would have been compensating somewhere. So we would work out where you are compensating and the chances are that something around the pelvis was a bit wonky from limping, and the other knee was having to work harder. So we work on the victim, and that’s important, but we also have to work on the bits that are compensating for it.
I would have probably done some work on your pelvis, which quite often stiffens up when you start limping, and then you start developing other problems. A really common issue with knees is that pelvises become tight as a result of limping.”
The point is, our bodies have an amazing capacity to heal. The problem is, it also naturally tries to compensate for the injured area if we carry on using it (which is often unavoidable). A physio can ensure that your body heals properly, strengthens the affected area for future use, and avoids further injury through the body trying to compensate for the injured area.
A big thanks to Nell for her help with this article.