MSK Physiotherapy

What we do

As a team we aim to promote, restore and maintain your physical capabilities, function and wellbeing. We provide specific advice and treatment to help you improve your function, return to your activities, and improve and maintain your quality of life.

Here at NHFT our physiotherapists are highly skilled, independent practitioners. Each specialises in their own areas of further learning and specific skill sets.

Musculoskeletal (MSK) Physiotherapy relates to physiotherapy for the injured and/or problematic areas of the muscular and skeletal system. This includes:

• Muscles and tendons
• Joints, ligaments and cartilage
• Fractures / broken bones
• Nerves

Advanced Physiotherapist Practitioners (APPs) are highly specialised clinicians who work at a higher level of varied advanced practice. Skills include:

• Diagnostics* (such as x-rays, MRIs and blood tests)
• Injection therapy
• Independent prescribing
• Provision of a fit note (Med3)

* Please note, we cannot request diagnostics for anyone under the age of 18 years.

Your care

Our care for you as a patient of the MSK Physiotherapy service aims to give you:

1. A better understanding of your problem
2. Treatment to help resolve your physical problems
3. The ability to better manage your problem day-to-day
4. More confidence while living with your problem
5. Support to live a less limited life

During your appointment - the initial conversation

The most underrated part of your appointment is our initial conversation with you about your symptoms. This give us the foundations we need to help you most.

We want to know

1. What the problem is
2. How the problem is affecting you
3. What you have been through
4. How you want us to help you
5. What you want to achieve with physiotherapy

This allows us to build a picture of everything that has come before and helps us to make the next steps as effective as possible.

During your appointment - the assessment

We use this part of the appointment to confirm our diagnoses from the questions we have previously asked.

On completion of the assessment, we will

1. Fully explain our findings and your problem to you
2. Explain the possible options for your treatment

This allows YOU to be involved in each step of this assessment and allows us to provide the most successful and personalised treatment possible. This is based on the best and most recent clinical evidence and our own clinical experience.

To fully assess and observe how a joint or area of your body is working, we may need to ask you to undress that area of the body. If you don't feel comfortable to do so, please let us know.

Check yourself

Deep vein thrombosis (DVT)

Cauda equina syndrome (CES)

Surgical wounds

Most surgical wounds heal up rapidly without and problems. However, a minority of surgical wounds do become infected. This occurs when germs enter the cut that the surgeon makes through your skin in order to carry out the operation.

Many germs live in and on our bodies and also in our environment. Most are harmless or even useful. Our bodies have natural defences against the germs that can cause harm. Our skin normally prevents germs from entering our bodies, but any break in the skin (whether due to injury or surgical incision) can allow them to enter and cause an infection.

URGENT: Any suspected infection should be taken seriously. If it is left untreated it can progress into a much more serious problem.

Signs and symptoms

MRI reports

Don't worry about what you read in MRI reports

When you have a scan the report will always show "stuff" (things like disc bulges, degeneration, dehydration and facet joint degeneration). However, research has shown this is rarely linked with pain.

People who have never had low back pain also have "stuff" on an MRI. This "stuff" can create a lot of worry that can distract from helpful activities like exercise. These things are normal parts of the ageing process - like grey hairs or wrinkles.

A scan is only essential if serious disease is suspected.

Common terminology

Don't be put off by common terminology

You may have heard terms like these in relation to discs, joints or bones:

1. "Out of place"
2. "Slipped"

Research has clearly shown that what is described by these terms does not happen to discs, bone or joints in your back.

Anatomically, your back is a strong, stable structure which is capable of lots of movement. If a person experiences a severe episode of back pain when lifting, nothing has fallen out of place - even though it might feel like it!

Pelvic health physiotherapy

Please note: this information is for people who have been referred to the pelvic health physiotherapy service by their GP or consultant. The service is only available to those referred by a healthcare professional.

What is pelvic health physiotherapy?

Pelvic health physiotherapy is a part of physiotherapy that helps with the health and function of organs in the pelvis, like the bladder, bowel, and uterus, as well as the muscles around them.

Our experienced physiotherapists can assist with issues such as leaking urine or stool, pelvic organ prolapse, and painful conditions in the pelvis, including vulvodynia, vaginismus, and pelvic pain.

These problems are often related to how well your pelvic floor muscles are working.

What can I expect at my physiotherapy appointment?

Your assessment will happen in a private room, and everything discussed will stay confidential. It's normal to feel a bit nervous before your appointment, but our team is here to help you feel comfortable and supported.

When you arrive, someone at Reception will welcome you and take you to the room for your assessment. To better understand your condition, your physiotherapist will ask you some questions about your symptoms, such as:

• When did your symptoms start, and what are they?
• Are there any activities or movements that make your symptoms feel better or worse?
• How many times do you go to the toilet during the day and night?
• How much and what types of drinks do you usually have?
• Have you had any tests or procedures for this issue?
• What medications are you currently taking?
• What do you hope to achieve through physiotherapy?

After going through these questions, your physiotherapist will talk with you about the physical examination, which may include an internal check-up.

What is an internal examination?

An internal examination is a way to check the health and condition of the muscles in your pelvic area. It can be done through the vagina or the anus. Your physiotherapist will first show you a model of the pelvis to explain what will happen during the exam.

The process is gentle, and we don't use any tools like speculums. We will only continue if you agree, and you can stop the exam whenever you want. You are welcome to bring a friend or family member with you, or you can ask for someone to be there with you for support if that makes you more comfortable.

What happens next?

Your physiotherapist will talk to you about what they found during your assessment, using pictures and models to make things clearer. Together, you'll create a treatment plan, which will probably include exercises tailored for your pelvic floor muscles and other related muscles. Feel free to ask questions anytime during your assessment. Your physiotherapist will usually schedule another appointment for you about 4 to 6 weeks later to check on how you're doing.

Further information