True Physiotherapy – Part One

 by Kate Greenaway-Twist, Goonellabah NSW

I have been working in Physiotherapy for over 30 years. I graduated from Sydney University in 1984 and worked in teaching hospitals for the next 2 years. For the following 6 years I worked in private practice, learning as much as I could from more experienced physios, but I found there was a hardness to the way physiotherapy was practised and so I went overseas in search of a more gentle way to treat the whole body.

In Boston, USA, I did courses introducing me to the importance of the connective tissue in the body. I experimented with more gentle ways of releasing this tissue for my many clients that had complex chronic spinal pain.

I came back to Australia in 1997 and moved to the Northern Rivers region of NSW, working in Community Health for 4 years full time and then 4 years part time. I treated the full range of ages and conditions, from babies to the elderly. Since 2002 I have been self-employed, working in a wonderful complementary healing clinic called Universal Medicine in Goonellabah and for 2 years until December 2016 I also worked in a family medical practice nearby. Over the years, I have undergone such a transformation in myself and my work that the way I am with patients, and how I approach my treatments with them now is a world away from even 15 years ago.

It has often been suggested to me by patients and other physios that – ‘you need to write about the work you are doing, share it with other practitioners, physios and people who are used to the old style of physio – and it has dawned on me that how I live, how I work, how I support my patients physically, emotionally and energetically is what I would call True Physiotherapy, which has inspired this article.

Almost all the physios I have met from when I graduated to now – have all had a genuine care for people, and they are very skilled at observing movement and analysing where the body is moving or performing in a dysfunctional way. The fundamental approach of standard physiotherapy is to problem-solve and implement methods of treatment that correct the dysfunctional joint movement, or excess muscle/soft tissue tension. All with the goal of decreasing pain and improving function.

There are 2 main problems with this approach:

  1. Having a treatment driven by a goal that the practitioner wants the body to achieve is imposing. It does not allow for the body’s natural healing processes to take place. I remember feeling it just wasn’t helping the body heal by pushing on joints to get them to loosen up or getting my patient to push their leg or arm against my arm and then stretch their limb forcefully for more joint movement and muscle length.
  2. The way physios are educated and practically trained is to focus on the one main area of physical dysfunction and symptoms. It is not about considering the body as a whole, and certainly doesn’t take into account the emotional status or energetic vitality of the person.

As a result, physios mostly look at the body with a very narrow focus – this reductionist approach may help an acute condition of one joint or body part and a few muscles, but it does not truly support the many patients who have chronic complex physical and emotional problems. As a young physio when I worked in this way I was always uneasy, as I knew this way was a) not considering big parts of the picture that made up the whole story for the patient and b) treating them in this narrow way was imposing on the body; it was me saying, I know how you should be and move, and this is the technique I will use to fix you’. Essentially, I realised this came with a force – even though I thought I was doing the ‘right’ thing. Many patients say to me now that they are often more sore for days or weeks after they have had standard physiotherapy treatment than they were before.

What was making me uneasy in treating in this standard way, was that it was not taking into account the bodys ability to heal itself.

The body has a remarkable intelligence to continually heal and bring itself to a greater level of balance and harmony. This includes everything in the body – the organ systems, nervous system and the movement system the musculoskeletal system.

Understanding the body in this way opened me up to consider the person in a truly holistic way – as a physical being, an emotional being and an energetic being. When I was a young physio, I was not trained in understanding how emotional stresses or poor vitality affected the body, leading to organ dysfunction and physical dysfunction. All I was focused on was what was the physical problem and how do I fix it. Now I consider all these factors and help support the person to understand the deeper disharmony in their body that eventually causes the physical problem. I gently assist the body to enhance its natural healing process and support the person to reconnect to their natural quality of gentleness.


Read more:

  1. True Physiotherapy – part 2.
  2. Holistic Physiotherapy – Patient Testimonials. 

332 thoughts on “True Physiotherapy – Part One

  1. Recently as a result of a referral, I had a phone conversation with a physiotherapist on the back of which I was emailed a set of exercises to follow. Just looking at the electronic demo made me panic as I could feel how inappropriate it would be for my body. I had to insist on receiving a physical assessment of my body.
    It would be awesome if the basic training for physiotherapists and other health professions covered the depth of understanding and care shared about here.

  2. There is a huge difference between focusing on bringing relief to a body and being from an ill-momentum and working with the body and being’s innate intelligence, as such the opportunity to truly address and heal an ill-momentum that in turn offers real support for us to evolve. The fact is that our systems in every sector of our society generally focus on providing relief, which is clearly not working and what you have presented here Kate is precisely what we need, to be open to working with more of the wisdom and intelligence of our body as this impacts every aspect of our lives, and all of us.

  3. Any practitioner will tell you (if they are honest) that when a client walks into their treatment room or clinic they are bringing their whole being with them and everything this means in terms of their emotional and spiritual issues or dilemmas, not just a sore arm or leg or back etc. And yet most Physiotherapists will try and just make it about the physical (because that is what we are trained to do) and will do their best to avoid or ignore the other aspects, even though they are impossible to really ignore or avoid. So no wonder there is stress, tension and exhaustion in practitioners!

  4. As for anything in life, the gentle approach may not bring that quick fix so we can carry on as we are. But it does help us shift gears and change how we are living over time so that we don’t get burnt out and ill from our excessive ways.

    1. Yes Leigh I agree. When we begin to honour the true quality of who we are in any aspect of life, what is offered is the truth from which we then know what changes or adjustments are needed or what needs deepening.

  5. I really love the first point about not imposing on a clients body but letting the natural healing process do its thing, this is very important for all modalities because at the end of the day the body heals itself and the practitioner is there to assist this and get whatever is in the way of this out of the way.

    1. Our bodies are such complex, intelligent things in their own right, able to regulate, adapt, heal… and equally tell us when something is not working, in dis-ease. We just have to learn to listen!

  6. Striving to achieve goals and outcomes in life doesn’t work, be it in physiotherapy, any healing modality, in relationships or in life generally.

    1. There is a huge difference between when we strive to achieve a preconceived picture, and in contrast when we choose to remain open, observe and respond to what is required with each unfolding moment. You only have to consider the difference between the two scenarios to recognise the debilitating limitation of the former.

  7. “Many patients say to me now that they are often more sore for days or weeks after they have had standard physiotherapy treatment than they were before.”- I can certainly attest to experiencing this same thing AFTER physiotherapy when I was beating my body up with multiple sports activities. I always felt like even though the physio’s did a good job, they were kind of trying to put a square peg into a round hole with their approach, and when a patient did not fit into the image they had based on their training, they would pretty much force the method in a way. It comes down to the patient not giving their power away in this instance and allowing themselves to feel what is right for them too in their treatment.

  8. Awesome to read of your steady unfolding to knowing that there must be more than treating a single part, and to embrace an understanding of the whole picture. This understanding is transformative when we choose to live from that awareness of the whole.

  9. This makes so much sense to me. How can the body truly heal if we are to only look at the physical and treat the body by manipulation to fix it? We think by moving parts of the body into place we’re getting somewhere but what caused or is causing the body to be in pain or discomfort in the first place? Surely there are others factors at play we need to address and consider in the healing and wellbeing of the client.

  10. Yes in my Physiotherapy training we did not even get taught basic counselling skills let alone any other training or consideration for looking at the whole person rather than just the physical complaint. As a result many practitioners feel unable to cope with the demands placed on them at work. So we need to consider a different approach to training that includes our amazing physical or manual skills but also considers other aspects of the health and wellbeing of the person.

  11. This is a super interesting insight into physiotherapy! It’s evidently so important to experiment with what works best for patients, customers and even in our working relationships, otherwise if we stick with one method forever or limit ourselves to the training ‘basics’ then we won’t evolve or come up with new ways of improving quality of care.

  12. I agree how the narrow focus, reductionist approach of traditional physiotherapy would be imposing on clients, and I also feel how it might cloud or possibly even deny the responsibility due on the client’s part. But at the same time, I wonder if that is actually where the demand has been – a quick fix that does not ask us to look at ourselves.

    1. That is a great observation Fumiyo – on both counts. It shows what an invaluable educational role a therapist of Kate Greenaway-Twist’s caliber can play for the public, by supporting a greater awareness about our personal relationship with our own health and healing.

  13. “how I live, how I work, how I support my patients physically, emotionally and energetically is what I would call True Physiotherapy” hear hear Kate. What you do is not just a job, it is a way you have with people –because of the way you live, and the skills that are applied in that way which brings the truth to physiotherapy.

  14. This is such a deeply empowering way to work with people and their bodies, to assist their innate wisdom and that of their bodies to heal and in that allowing the body to ‘dictate’ the pace, allowing for a gorgeous collaboration with therapist and client. I am so glad you shared this Kate, this is how true physiotherapy can be, and it’s great to hear the living proof of it.

Leave a Comment

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s