• Alison Annison

Who to see when you hurt?

As the resident massage therapist at Unit 7, I primarily do sports massage, but I see a nice variety of people, from tourists who have overdone it on the first day of their golf holiday, to locals with a challenging range of complaints, and plenty of recreational sports people, as well as the occasional professional athlete. It’s engaging, and I enjoy it, even when I get asked questions which I don’t know the answer to, which is pretty often.

Being of a curious mind I endeavoured to find some answers by undertaking a degree in strength and conditioning. Even after graduating, I still get asked questions that I can’t answer because folk are really good at asking tricky questions. But one thing I have learned - that nobody really knows for certain what cramp is or what causes it….

One area of query I have become relatively good at answering is on the difference between various healthcare practitioners. (A lady once confidently told me she had seen a chiropath. I then learned that osteopractor is apparently a thing).

A surprising number of people are unclear about the difference between what a sports massage therapist can do and what a physio can do – the difference being a degree and several years of training. A physio can use a thorough history, a variety of tests, and clinical reasoning to diagnose musculoskeletal complaints and then agree the best course of treatment with you.

Massage is mostly about muscles and connective tissue and a good massage therapist should recommend physio (or GP or similar) if they feel your issue is beyond their scope of practice. There is crossover between different types of practitioner, I myself have been on various courses to improve my skills, and have learned alongside physios, osteopaths, chiropractors, and even pain specialist nurses.

Even within a profession, a practitioner will develop their own interests and base their practice around it, so you can see three different doctors, or osteos, or physios and get three different solutions to your complaint. My own particular interests have evolved into the area of strength training. And pain. I’m interested in how pain works and how it affects people and of course what can be done about it. But more on that in the future.

So how do you decide whether you need to see a massage therapist, physio, Bowen practitioner, osteopath, chiropractor, personal trainer, or any other type of therapist? There are so many adverts out there, so much conflicting information on the internet, and so made claims and promises of "one simple trick", it's mind blowing and can lead to a feeling of helplessness as well as confusion. The answer? It largely depends on what you wish to get out of the treatment.

As a rule of thumb, massage is great for soft tissue aches, pains and stresses. If you want to give yourself a bit of well deserved attention it's perfect. If you're sporty, active, or do a physically demanding job, a regular massage can be beneficial not just for chilling out and getting loose but also in drawing attention to any potentially developing niggles, allowing them to be addressed early.

However, if you have a new musculoskeletal problem, especially one which has no obvious cause, then you should probably see a physiotherapist. It is beyond the scope of this article to differentiate between osteopathy, chiropractic, or any combination of the two, or to discuss the waiting times for NHS physio. I would suggest doing your homework, if you have a complaint you think could be helped by a private practitioner of any profession, research them and ask them questions. If you're happy with the answers then go ahead and book. This advice rings true for massage too by the way, find a therapist that is a good fit.

Recommendations from friends and family are useful, if they trust a professional then that's a start. Just bear in mind that just because your mate got a good result with his Achilles tendinopathy, it doesn't guarantee that you'll get the same with your 25 year history of back pain. We practitioners really appreciate word of mouth recommendations but it does put the pressure on us.

All good health-related professions have governing bodies with websites you can visit. There is a lot of conflict about evidence of efficacy amongst different treatments, and whilst I love my science and I like to know how things work, I accept that a lot of the time we just don’t know, and it’s ok to admit it. If you feel a treatment benefits you and you have a positive relationship with the provider, then it’s a good thing. If you feel you’re not getting anywhere, then try something else. There is, sadly, no one treatment that will work for all people all the time.

Now I am fully flaunting my biases here, but over the years I have come to realise that prevention is preferable to cure. Lifting weights with fully functioning joints and muscles is a lot less painful than doing physio exercises after damaging a tendon because strength or recovery was lacking. I’m not really a subscriber to the “no pain no gain” school of thought. No pain no brain, on the other hand, there might be something in that.


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