The Profession of Physiotherapy
In celebration of World Physiotherapy Day on Wednesday 8th September, this week’s blog is all about the profession of physiotherapy and the sub branch of equine and equestrian physiotherapy as well as the broader topic of animal physiotherapy or veterinary physiotherapy as it is referred to internationally.
What is animal (or veterinary) physiotherapy?
To explore what animal physiotherapy is all about, we must first explore the profession of physiotherapy itself, as animal physiotherapy is but a small branch of the giant tree of the overall physiotherapy profession.
Physiotherapy is an allied health profession which employs physical treatment techniques and modalities to restore, maintain and improve health, function, performance and well-being. Traditionally, physiotherapy care has been focused on human health care.
Allied health means that a physiotherapist will work alongside other health care professionals involved in a patient’s care, as a member of that patient’s multi-disciplinary healthcare team. For humans, this means your physiotherapist will work alongside your G.P., your surgeon or medical specialist, your coach along with a huge range of other healthcare professionals. With regard to animal healthcare, that means your physiotherapist will work closely alongside your veterinary team. In fact, both professions complement each other, hence the term ‘complementary’ often being used to describe physiotherapy as a profession.
Physiotherapists are experts in assessing, problem solving and treating a wide variety of issues which have an adverse effect on normal and healthy movement, function and quality of life. You might be surprised to learn that the attention of a physiotherapist extends far beyond your musculoskeletal system!
As an undergraduate student, every up and coming physiotherapist must gain comprehensive theoretical and practical skills working across the three core areas of human healthcare – musculoskeletal physiotherapy, neurological physiotherapy and cardiovascular physiotherapy. They will also gain some experience in a range of more specialised areas e.g. paediatric physiotherapy or pelvic floor physiotherapy.
Physiotherapists spend up to four years fine tuning their understanding of the application of physiotherapy in each of these three core areas and will spend a minimum of 1000 hours on supervised clinical placement in the hospital and community rehabilitation settings. Early on in a physiotherapists career, they will likely spend a few years rotating as a junior physiotherapist throughout a range of clinical areas, consolidating their knowledge and clinical reasoning skills. As a physiotherapist becomes more experienced and advances in their career pathway, they are likely to focus on and specialise within a particular clinical area.
Physiotherapy is a very interesting profession in that there are many different specialities nestled under the umbrella term of physiotherapy, including but not limited to the following areas:
Musculoskeletal physiotherapy
Orthopaedic physiotherapy
Neurological physiotherapy
Cardiovascular physiotherapy
Women’s and men’s health physiotherapy
Paediatrics physiotherapy
Lymphoedema physiotherapy
Aged care physiotherapy
Pain management physiotherapy
Animal Physiotherapy – small animal physiotherapy and equestrian physiotherapy
What is a physiotherapist?
The title 'physiotherapist' is a protected title. To gain a qualification in physiotherapy, a physiotherapist must complete an undergraduate degree or postgraduate study in physiotherapy. In addition, they must register with the physiotherapy board of their country of practice. In Australia, this regulatory board is AHPRA, the Australian Health Practitioner Regulation Agency.
In order to maintain registration with AHPRA, a physiotherapist must commit to the following:
Undertaking a specified amount of continuing professional development each year - ensuring each physiotherapist keeps their knowledge up to date and is aware of the emerging research which guides their practice.
Physiotherapists must complete a specified number of hours per year of clinical practice with (human) patients.
Commit to a code of conduct and code of practice.
Carry adequate professional indemnity insurance to practice.
What about Equine Physiotherapy, Rehabilitation and Therapy?
Unfortunately, when it comes to rehabilitation and therapy, our horses do not enjoy the same level of protection as humans. At present, equine rehabilitation is a largely unregulated industry in Australia and in many parts of the world. This means that you, the guardian or person in your horse’s life, must be diligent and ensure that if you do choose the profession of physiotherapy as the health professional to entrust the animal in your care, that the therapist you choose is actually a fully qualified physiotherapist.
Furthermore, you need to also check that your physiotherapist has undergone appropriate postgraduate training to specialise in animal physiotherapy. You would not see your G.P. or nurse for physiotherapy for yourself, as physiotherapy would be outside of their scope of practice. Of course, this works both ways – you would not see your physiotherapist for care that falls under the scope of practice of the medical (or veterinary) field e.g. surgery, prescription of medication etc or diagnostics in equine healthcare. So, it is important that if it is physiotherapy that you are seeking, that you check the qualifications of the professional offering physiotherapy services for your animal.
You can easily check to see that the professional you have chosen is indeed a qualified and registered physiotherapist. You can consult the AHPRA database here and search for their details and check that they are registered on the AHPRA database.
Post graduate study in Animal Physiotherapy
Internationally, the gold standard route to specialising in animal physiotherapy is via a Post Graduate Diploma or Masters in Veterinary Physiotherapy. This training route was available in Australia up until recent years, but unfortunately the course is no longer offered by Australian Universities.
Physiotherapists who wish to specialise in animal physiotherapy, and who wish to study and train to the highest standard available internationally must study via post graduate courses offered in the UK. Fortunately, Australia now has well established ties with the University of Liverpool in the UK. Post graduate students dedicate a minimum of two years to post graduate study, to achieve a Post Graduate Diploma in Veterinary Physiotherapy. The course work involves online learning, several weeks of practical residencies (in Australia and the UK), along with clinical placements with both veterinarians as well as qualified physiotherapists.
In Australia, physiotherapists mostly complete the theoretical learning virtually (something we are all very familiar with now in times of COVID!), alongside their colleagues in the U.K. and in Europe, and complete the practical components of the course (residencies) in Australia, alongside their Australian and New Zealand peers.
In the UK, fully qualified physiotherapists first earn the title of ‘Chartered Physiotherapist’ before they can practice physiotherapy with humans. This means that they can then apply to register with the Health Professionals Council and become members of the Chartered Society of Physiotherapy, the professional membership organisation for physiotherapists in the UK. This is similar to AHPRA (our regulatory body) and the Australian Physiotherapy Association (our professional body) in Australia.
It is worth highlighting the Association of Chartered Physiotherapists in Animal Therapy (ACPAT), a professional network of the Chartered Society of Physiotherapy which represents the interests of Chartered Physiotherapists in Animal Therapy in the UK and overseas. ACPAT physiotherapists work closely with referring veterinarians and are very highly regarded internationally.
In summary, when considering physiotherapy for your animal, we recommend that the physiotherapist you choose for your animal meets the following standards:
Holds a Degree or Masters in Physiotherapy
Is a fully registered physiotherapist with AHPRA
Holds a Post Graduate Diploma or Masters in Animal (Veterinary) Physiotherapy
Equestrian Physiotherapy
Equestrian disciplines are truly unique in the athletic world, where both horse and rider work together as a team. This teamwork has been eloquently described by the author R.S. Surtees…
“There is no secret as close as that between a rider and his horse”.
So close is the relationship between horse and rider, that how the rider moves (both intentionally and unintentionally), directly affects how the horse moves, and vice versa. This can have both positive and negative consequences. Negative consequences arise when either the horse or rider have musculoskeletal impairments including injury, muscle weakness, joint restriction, suboptimal motor control patterns or poor balance, coordination or proprioception. Such musculoskeletal impairments often lead to dysfunction and ultimately a breakdown in communication between horse and rider.
Given that rider position, posture and movement play a vital role in performance, regardless of discipline, it is important that the horse and rider are assessed both individually, in addition to being assessed as a team. When our horse isn’t performing to its potential, and our riding isn’t going to plan, we often assume that the problem lies with our horse. All too often the horse is assessed by the veterinarian, dentist, farrier, saddler and physiotherapist before a rider assessment is even considered. Sadly, many horses are simply written off as having behavioural issues, being lazy or just plain difficult if no physical reason for sub-optimal performance is identified.
Given that the rider comprises 50% of the equestrian unit, it is of paramount importance that the rider is also fully assessed by the physiotherapist, so that any impairments can be addressed.
The beauty of working with a qualified physiotherapist is that you can receive physiotherapy care for yourself, alongside your horse. In fact, optimal equestrian physiotherapy care involves taking a holistic approach and assessing not just the horse – but the horse, the rider and the horse and rider together.
Equestrian physiotherapy involves the following:
Assessment of the horse individually
Assessment of the rider individually
Assessment of the horse and rider as a team (mounted assessment)
Treatment of both horse, rider and the horse and rider team
Outcome measures – to assess the effect of our chosen treatment techniques (e.g. assessment of range of motion, stretch, performance).
Goal setting and goal achievement!
By prioritizing and optimizing our own health, fitness, strength, flexibility, coordination, balance and proprioception, we strive to be the best partner that our horse deserves.
“If your horse says “no”, you either asked the wrong question, or asked the question wrong”
~ Pat Parelli