returntoperformancephysiotherapy

Red Flags to Watch Out for When Selecting a Physiotherapist

Wed, 15 Jul 2026 01:19:47 GMT

Red Flags to Watch Out for When Selecting a Physiotherapist

Most physiotherapists are competent, caring professionals who genuinely want to help you. But like any field, physiotherapy has its share of practitioners who are rushed, outdated, overconfident, or simply not the right fit for your needs.

The problem is that it can be hard to tell from the outside. A slick website and a wall full of certificates won't tell you whether someone actually listens, keeps their practice evidence-based, or will adapt their approach when things aren't working.

Here are the warning signs to watch for — before you've committed your time, money, and body to the wrong person.

Red Flag #1: No Proper Assessment Before Treatment Begins

A thorough assessment should precede every treatment plan. This means taking a history, asking about your goals, running relevant physical tests, and forming a hypothesis about what's going on before touching you therapeutically.

If you arrive at your first appointment and the physio is already mobilising your spine or dry needling you within minutes — without any meaningful assessment — that's a problem. Treatment without assessment is guesswork.

This matters because what presents as one type of problem can turn out to be something quite different. Jumping straight into treatment without proper evaluation can miss the real cause, mask symptoms without addressing them, or in some cases make things worse.

Red Flag #2: Vague or Dismissive Explanations

You deserve to understand what's happening in your own body. A good physiotherapist takes the time to explain their findings in plain language — what they think is going on, why, and how the proposed treatment addresses it.

Watch for:

"It's just wear and tear" — with no further explanation of what that means or what can actually be done
"You'll just have to live with it" — without having explored all options
Medical jargon dumped on you without interpretation
Dismissing your questions as if they're inconvenient or outside your ability to understand

You're not expected to have a medical degree. But your physio should be able to explain their reasoning in terms that make sense to you. If they can't or won't, that's a communication problem — and communication is fundamental to good care.

Red Flag #3: Treatment That Never Changes

Every physio who has treated more than a handful of patients knows that some things work and some things don't — and what works differs from person to person. If your treatment is exactly the same session after session with no evolution, that should prompt questions.

An evidence-based physiotherapist will:

Progressively load your exercises as you get stronger
Adjust manual therapy techniques based on your response
Re-evaluate periodically and update the plan accordingly
Change tack if progress stalls

Static, cookie-cutter treatment plans are a sign of someone applying a protocol to you rather than treating you. Your body changes through rehabilitation — the plan should change with it.

Red Flag #4: Passive Treatment Without Active Rehabilitation

Hands-on treatment — massage, dry needling, joint manipulation — has real value. But if every session ends with you lying on a table feeling temporarily better, without you having done any active work yourself, something is missing.

The evidence is clear: for most musculoskeletal conditions, active rehabilitation (exercise, strength work, movement retraining) produces more durable results than passive treatment alone. A physio who never prescribes exercises, never teaches you how to manage your own condition, and never builds your capacity to move better independently is creating dependency — not recovery.

This doesn't mean passive treatment is bad. It means passive treatment in isolation is usually insufficient.

Red Flag #5: Encouraging Indefinite Treatment Without Clear Goals

Some conditions do require ongoing management — chronic pain, certain neurological conditions, hypermobility disorders. Ongoing care can be legitimate and valuable in these cases.

But if a physio is encouraging you to book indefinitely without clear goals, milestones, or any plan for discharge — and there's no specific clinical reason for ongoing management — ask yourself whether this is actually in your best interest.

A transparent physiotherapist will give you a realistic timeframe, track your progress against objective measures, and have an honest conversation when you've reached a plateau. They'll also tell you when you've graduated from weekly appointments to intermittent check-ins.

Red Flag #6: Dismissing Other Healthcare Providers

Physiotherapy doesn't exist in isolation. For complex or multi-faceted conditions, you might also be seeing a GP, a sports medicine doctor, a specialist, or a psychologist. A good physiotherapist communicates and collaborates with others in your care team.

Be cautious of a physio who dismisses every other opinion, discourages you from seeking a second opinion, or suggests that other practitioners are wrong without offering specific clinical reasoning. Confident clinicians welcome scrutiny. Insecure ones don't.

Red Flag #7: Not Registered With AHPRA

This one's non-negotiable. In Australia, anyone calling themselves a physiotherapist must be registered with the Australian Health Practitioner Regulation Agency (AHPRA). Registration confirms they've completed an accredited degree and are bound by professional and ethical standards.

You can verify registration at ahpra.gov.au . It takes less than a minute. If the person you're seeing isn't registered, they are not legally practising as a physiotherapist in Australia — regardless of whatever titles or credentials they display.

Red Flag #8: Rushing You Through Appointments

Short appointments aren't inherently a problem — some conditions are genuinely straightforward and don't require long sessions. But if you consistently feel rushed, don't get time to ask questions, and leave without feeling like you've been fully heard, that's worth paying attention to.

A physiotherapist who is seeing back-to-back patients with virtually no transition time often can't give each one the attention they deserve. High-quality care requires time to assess, treat, and communicate properly.

Red Flag #9: Making Overpromised Guarantees

Ethical practitioners don't guarantee outcomes. Recovery depends on many factors — your specific condition, your adherence to the plan, your overall health, and yes, a degree of natural variation. Anyone who promises specific results by a specific date — or worse, implies that your failure to improve is entirely down to not trying hard enough — is overstepping.

What a good physio can promise is a thorough assessment, an evidence-based plan, honest communication, and a willingness to adapt. That's a reasonable thing to expect. Guaranteed outcomes are not.

Red Flag #10: No Focus on Your Goals

This one's subtle but important. Your physiotherapist should be as interested in what you want to achieve as in what's wrong with you.

There's a difference between "reducing pain" and "getting back to competitive football." Between "improving range of motion" and "being able to pick up my kids without wincing." A physio who isn't asking about your goals, or who treats the symptom while ignoring the functional context, is leaving half the job undone.

What Good Actually Looks Like

A great physiotherapist is thorough but efficient. They explain clearly. They build a plan around your goals and adapt it as you progress. They empower you to understand your own body rather than making you dependent on them. And they're honest — about timelines, about limitations, about when you might need a different type of help.

If you're looking for that kind of care in Bendigo, book an assessment with Return to Performance Physiotherapy and see the difference a properly individual approach makes.

What Questions Should You Ask Your Physiotherapist During Your First Visit?

Wed, 01 Jul 2026 00:26:24 GMT

What Questions Should You Ask Your Physiotherapist During Your First Visit?

Most people walk into their first physiotherapy appointment in a fairly passive mindset — they describe their problem, the physio does their thing, and they leave hoping it'll help. That's understandable. But it's also a missed opportunity.

Your first appointment is a two-way evaluation. You're assessing whether this physiotherapist is the right fit for you just as much as they're assessing your injury. Coming prepared with the right questions changes the entire dynamic — you get better information, your physio understands you better, and you leave with a clearer picture of what recovery actually looks like for you.

Here are the questions worth asking.

Questions About Your Diagnosis

"What do you think is causing my pain or problem?"

This is the most important question you can ask. You want a clear, plain-English explanation — not just a technical term delivered with confidence.

A good physiotherapist won't hedge excessively. They'll give you their working diagnosis, explain the reasoning behind it, and be upfront about any uncertainty. If they say something like "it's probably your rotator cuff based on these movements, but I want to rule out X before we commit to that," that's actually a great sign — it shows clinical reasoning, not guesswork.

If the answer is vague or you're handed a diagnosis with zero context, push for more. "Can you explain what that means in practical terms?" is a perfectly reasonable follow-up.

"Is there anything I need to rule out before we start treatment?"

Physiotherapy is appropriate for a huge range of conditions, but some symptoms need medical investigation first — persistent unexplained weight loss, pain that's unrelated to movement, bowel or bladder changes, and certain patterns of neurological symptoms can indicate something beyond a musculoskeletal issue. A thorough physiotherapist will screen for these. Ask whether they've considered any of these factors.

"What's actually happening in my body — structurally or functionally?"

Understanding why you hurt is motivating and useful. Is it a tendon that's been overloaded? Muscle weakness creating compensation patterns? Joint stiffness following immobilisation? Knowing the mechanism helps you understand the treatment.

Questions About Your Treatment Plan

"What does treatment look like from here?"

Ask for a rough roadmap. How many sessions are we talking? What will we be doing in those sessions — is it mostly hands-on work, exercise-based, or a combination? Will the approach change over time?

You don't need a precise timeline (most good physios will tell you that recovery varies), but you should get a general sense of phase 1, phase 2, and what "done" looks like.

"How will we know if treatment is working?"

This is one that most patients never think to ask — but it matters. What are the measurable markers of progress? Is it range of motion, strength tests, pain levels during specific activities, return to a particular sport or task?

Having objective milestones serves two purposes: it keeps you motivated when progress feels slow, and it gives you both a clear signal if something isn't working.

"What should I be doing between sessions?"

Physiotherapy is not something that only happens in the clinic. If your physio isn't giving you exercises, stretches, or movement guidelines to follow at home, that's a red flag. The work you do between appointments largely determines how quickly you progress.

Ask how often you should do the exercises, how they should feel (mildly uncomfortable is usually fine, sharp pain is not), and what to do if something doesn't feel right.

"Is there anything I should avoid doing while we're treating this?"

Sometimes the answer is "nothing — keep moving," and sometimes there's a specific activity or load that needs to be modified while things settle. Either way, you want to know so you're not inadvertently undoing progress.

Questions About Prognosis and Expectations

"How long does this typically take to resolve?"

Be realistic here — physios can't guarantee timeframes, and anyone who gives you a suspiciously precise answer probably should be treated with some scepticism. But they should be able to give you a range based on what they're seeing and what they know about similar cases.

"Usually 6–12 weeks with consistent effort" is a useful answer. "It depends" with no further context is not.

"Is full recovery realistic, or is this about managing the condition?"

This matters especially for chronic conditions, post-operative rehab, or degenerative changes. Some conditions are fully resolvable. Others are better framed around management and function than "cure." An honest answer here lets you calibrate your expectations and approach treatment with the right mindset.

"What happens if this doesn't improve as expected?"

A good physio will have a plan B — whether that's adjusting the treatment approach, referring you to a specialist, ordering imaging, or requesting a second opinion. Ask this not because you expect things to go wrong, but because it shows you whether they're thinking long-term and whether they'll keep adapting until they find what works.

Questions About Your Specific Situation

"Have you treated this condition or type of injury before?"

Experience with your specific issue isn't always necessary — good clinical reasoning transfers across conditions — but it's still reasonable to ask. If you have a complex or less common condition (hypermobility syndrome, a rare nerve entrapment, a sport-specific overuse injury), knowing whether your physio has direct experience can be reassuring.

"Is there anything about my lifestyle or work that I should flag with you?"

Your job, hobbies, sleeping position, footwear, gym routine — all of these can influence both the cause of your problem and how effectively treatment works. Proactively raising these gives your physio more to work with.

"What can I expect to feel after today's session?"

Some post-treatment soreness is normal — particularly if dry needling, joint mobilisation, or significant soft tissue work has been involved. Knowing what to expect helps you distinguish between normal treatment soreness and something worth reporting.

The Meta Question: Do I Feel Comfortable Here?

Beyond specific questions, pay attention to how the conversation flows. Do you feel like you can ask questions without being rushed? Does the physio explain things clearly, or does everything feel wrapped in jargon? Do they acknowledge your concerns or brush past them?

The physiotherapist-patient relationship works best when there's genuine two-way communication. If you leave your first appointment feeling clearer about your situation and confident in the plan, that's a good start. If you feel confused or unheard, it's worth either raising it directly or reconsidering whether this is the right fit.

Ready to Book?

If you're in Bendigo and looking for a physio who will actually take the time to explain what's going on — and give you a plan that goes beyond symptom management — we'd love to help. Contact Return to Performance Physiotherapy or call (03) 5448 5556 to book your first assessment.

How to Choose the Right Physiotherapist for Your Needs

Mon, 15 Jun 2026 05:37:21 GMT

How to Choose the Right Physiotherapist for Your Needs

Choosing a physiotherapist isn't something most people spend a lot of time thinking about — until they actually need one. Then it suddenly matters a lot.

Whether you're dealing with a sports injury, recovering from surgery, managing chronic pain, or just trying to move better, the right physiotherapist can make a significant difference in how quickly and completely you recover. The wrong one? You'll plateau early, waste money, and potentially come away more frustrated than when you started.

Here's how to get it right.

Start With What You Actually Need

Before you search for anyone, get clear on your situation. Physiotherapy covers a wide range of conditions and treatment approaches — and not every physio specialises in the same things.

Ask yourself:

Is this a sports-related injury or performance issue?
Are you recovering from surgery?
Do you have a chronic condition like arthritis, hypermobility, or a neurological disorder?
Is this pain management, or are you chasing a performance goal?

This matters because physiotherapy is a broad field. A physio who's brilliant at managing post-operative knee rehab might not be the right fit for an elite athlete trying to reduce their injury risk. And one who works primarily with aged care patients might not have the sports science background you need if you play competitive sport.

Be honest with yourself about what you're actually looking for.

Check Their Qualifications and Registration

In Australia, physiotherapists must be registered with the Australian Health Practitioner Regulation Agency (AHPRA). This is non-negotiable. Registration means they've completed an accredited university degree (typically a four-year Bachelor or two-year Masters) and are bound by professional standards.

You can check a physio's registration status directly on the AHPRA website . It takes about 30 seconds and removes all doubt.

Beyond base registration, look for additional qualifications relevant to your needs:

Strength and conditioning accreditation (such as an ASCA Level 1 or higher) is valuable if you want a physio who understands athletic performance, not just injury repair
Post-graduate training in areas like sports physiotherapy, musculoskeletal physiotherapy, or pain management signals someone who has gone deeper in their field
Experience with specific conditions — ask directly whether they've treated your type of injury before

At Return to Performance Physiotherapy, our Head Physiotherapist Chris Adkins holds both a physiotherapy qualification and an ASCA Level 1 Strength & Conditioning accreditation. That dual background shapes the entire treatment philosophy here — recovery isn't just about reducing pain, it's about rebuilding strength and function.

Look for a Physio Who Listens

This sounds obvious, but it gets overlooked constantly.

A good physiotherapist takes a proper history before they do anything else. They want to know how the problem started, what aggravates it, what eases it, what you've tried already, and — critically — what you want to be able to do when this is resolved.

If you walk into an appointment and the physio barely asks you anything before they're already working on you, that's a problem. Treatment that isn't informed by your individual situation is generic at best and counterproductive at worst.

Watch for these signals in the first session:

Do they ask about your goals, not just your symptoms?
Do they explain what they think is going on and why?
Do they outline a treatment plan that makes sense for your life and timeline?
Do they give you homework — exercises or lifestyle adjustments — rather than just expecting you to come back and lie on the table?

The best physiotherapists are educators. They want you to understand your own body so you can play an active role in your recovery.

Consider the Setting and Equipment

Where a physiotherapist works says something about how they work.

A clinic that's essentially just a row of treatment tables with curtains separating them is set up for passive treatment — massage, joint mobilisation, electrotherapy. That has its place. But if your goal is functional recovery, you want a clinic where active rehabilitation is possible.

Look for:

Access to gym equipment — resistance bands, weights, cable machines — for progressive strength work
Technology for assessments — things like force plates can provide objective data on how you're moving and where the asymmetries are
Space to move — you should be able to walk, jog, squat, and lunge if that's relevant to your rehab

At Return to Performance, all treatments are facilitated in a fully-equipped gym. This isn't incidental — it reflects a belief that getting stronger is central to getting better, not an afterthought you do once the "real" treatment is done.

Ask About Their Treatment Philosophy

Every physiotherapist has a philosophy, even if they've never articulated it explicitly. Some lean heavily on hands-on treatment (massage, dry needling, joint manipulation). Others prioritise exercise-based rehab. The best integrate both.

The question to ask is: "What does your typical treatment approach look like for someone with my condition?"

A good answer will include:

A mix of manual therapy and active rehabilitation
A plan that progresses over time — not the same set of exercises every session
A realistic timeframe and honest conversation about expectations
An exit strategy — a point at which you no longer need to come in weekly

Be cautious of any physio who can't give you a rough timeline, implies you'll need indefinite ongoing treatment, or dismisses exercise as important.

Location and Practicality Matter More Than You Think

The best physiotherapist in the world is no good to you if getting there is a hassle that means you'll skip appointments. Consistency is everything in physio. Find someone you can see regularly without it becoming a logistical nightmare.

That said, don't sacrifice quality purely for convenience. A slightly longer drive to see a physio with the right expertise will almost always be worth it compared to seeing someone local who's not the right fit for your specific needs.

Don't Ignore Word-of-Mouth

Ask around. Personal recommendations from people who've dealt with a similar issue carry a lot of weight. A friend who's seen a physio for ACL rehab and had a great result is a much more reliable source than a generic Google search.

When you get a recommendation, ask:

What was the condition they were treating?
How long did treatment take?
Did the physio actually explain what was happening?
Would they go back?

Online reviews have value too — but treat them with some nuance. More on that in a separate post.

Trust Your Gut in the First Session

After your first appointment, you should feel like you understand more about your body and what's going on, have a clear plan, and feel confident that this person knows what they're doing.

You shouldn't feel rushed, confused, or like you've just paid for someone to push on your back for 20 minutes without explanation.

If the first session doesn't give you confidence, it's okay to seek a second opinion. You're not locked in. The right practitioner will welcome your questions and be happy to explain their reasoning.

The Bottom Line

Choosing a physiotherapist comes down to three things: relevant expertise, a genuinely individualised approach, and clear communication. Those three qualities will take you further than proximity or price every time.

If you're in the Bendigo area and want a physio team that blends traditional assessment with progressive strength-based rehabilitation, we'd love to meet you. Book an appointment with Return to Performance Physiotherapy and let's figure out what your body needs.

Return to Performance Physiotherapy is located at 41 Howard Street, Epsom VIC 3551. Call us on [(03) 5448 5556](tel:0354485556) to discuss your needs.

Osgood Schlatter’s - Why my kids always complain about their sore knee

Tue, 28 Apr 2026 22:49:39 GMT

Osgood Schlatter Disease (OSD)

Osgood Schlatter Disease (OSD) is a growth related disease located at the knee within the similar entity of growth related disease as severs developing at the hind aspect of the heel. OSD involves the development of apophysitis (irritation at the growth plate between the tibial tuberosity and main tibia bone) at top and central part of the tibia known as the tibial tuberosity. Tibial tuberosity is a primarily fibrocartilaginous structure during the early development stage (<8yrs girls, <9yrs boys) which undergoes the process of ossification (laying down of bone) between the ages of ~8-14 with the presence of an growth plate between the tibial tuberosity and the tibial metaphysis (head). Complete ossification or fusion of previous growth plate (complete bony fusion between tibial tuberosity and tibial shaft ends) to form one complete bone is expected to have taken place by around the age of 15+ year for girls and 17+ years for boys.

Onset is insidious with a gradual worsening presentation without trauma common during the years 9-17 years for males and 8-15 years for females whereby skeletal immaturity coincides with adolescent growth spurts or peak growth years being 11-15 years for girls and 13-16 years for boys. Prevalence rates of the disease during the peak growth years range from 9-12% of children.

OSD develops on the background of increased patella tendon traction on the tibial tuberosity secondary to the lag between increased bone growth (femoral shaft lengthening) and tendon and muscle lengthening adaptation resulting in increased traction stress at the growth plate leading irritation within this region termed ‘apophysitis’.

Imaging is not a routine requirement as part of diagnosing OSD with a thorough clinical examination generally providing enough conclusive information necessary to make the diagnosis. There is a strong association with the development of OSD within a short time period during or post a peak growth period, sudden increase volume of physical activity or introduction to those sports such as football, gymnastics or netball/ basketball. Sports which require repeat jumping, landing, change of direction, acceleration or deceleration or sustained periods of sprinting components across a continuous period (half or quarter). Symptoms generally present below the patella with a focal distribution around the patella tendon and insertion in the tibia. Acute symptoms will generally subside with a period of rest ranging from minutes through to 24 hours dependent on severity of ‘apophysitis’ present. Other common predisposing factors including poor quadricep, hamstring and soleus flexibility/length, poor quadriceps strength/plyometric control, poor pelvic control and abnormal dynamic foot posture/ biomechanics.

Treatment and management of OSD is centred around managing symptoms until the apophysis fuses. Generally, OSD has an excellent prognosis with full resolution of symptoms within 6 months of good quality conservative treatment when following the prescription of a thorough individualised impairment targeted rehabilitation program. Effective management includes but is not limited to patella tendon style compression taping or bracing, modification of the above modifiable predisposing factors and load management. It’s important to note that while frequency of exercises can reduce to 1-2x weekly post initial ‘rehabilitation phase’, to maintain current strength/plyometric adaptations it is important your child remains consistent with their exercises until full apophysis fusion has occurred to prevent re-lapse and re-flaring of symptoms. Alongside this during the phase of a growth spurt risk for re-flaring of symptoms does increase, if symptoms during this period are unable to be effectively managed with reducing workloads and increasing soft tissue releasing techniques, totally withdrawing the child from the provocative activity/sport until symptoms settle and the lag between tendon/muscle lengthening adaptation has taken place in regards to recent bone growth (lengthening) may be necessary.

Acute management of Soft Tissue Injuries

Fri, 17 Apr 2026 02:15:16 GMT

Effectiveness of Acute Treatment on Return to Sport timelines

No one enjoys watching from the sidelines, to improve players/athletes’ ability to return to play and minimise days off during the rehabilitation period, commencing acute treatment within the first 24-48hrs is critical. Re-injury rates post soft tissue injury are heavily publicised with recurrent hamstring injuries being most common at 9%, 5% (quadriceps), 2% (calf) and 6% (groin) (Orchard, 2020). While the incidence of soft tissue injuries remains elevated a thorough examination and tailored rehabilitation program has been demonstrated consistently throughout research to improve an athlete’s ability to return to sport, reduce re-injury rates and minimize days missed due to injury.

What Acute Treatment Looks Like

Early (with the first 0-48hrs) and comprehensive acute management leads to earlier restoration of muscle strength and power leading to earlier reintegration into sports-specific training ensuring return to sport times aren’t delayed and risks for tissue re-injury are mitigated.

Aim of early management should include management of pain and reduction of swelling (if present) supporting optimal healing while introducing low stress/load adjuncts to reduce the loss of muscle tissue deconditioning early on without compromising healing. Following up with your local physiotherapist within the first 24hrs is optimal to provide essential information regarding diagnosis, referral for imaging if required and provide support regarding management of acute symptoms.

The ‘gold standard’ of early treatment follows the acronym ‘RICE’, there are many variations of this acronym however essentially include the same elements.

R Relative Rest

I Ice

C Compression

E Elevation

Relative Rest- Includes protecting the injured tissue to allow optimal healing without providing additional stress which may be detrimental to healing. This can range from a brief period of non-weightbearing through to limiting volume of walking/ weightbearing.

Ice- Includes application of ice frequently throughout the first 48-72 hours for 15-20mins with 30-60min breaks 4-8 times daily (Smith, 2005)

Compression- Includes application of compression sleeve to reduce to the amount of swelling/inflammation accumulation for 2-7 days dependent on severity of tissue injury. Application of compression most is important throughout the day when weightbearing or when the limb is not in a position of elevation.

Elevation- Includes keeping the injured limb on a pillow/towel above the level of the heart. Further supporting reducing the accumulation of swelling. This is to be completed frequently and for extended periods throughout the first 48-72 hours.

Why Physiotherapy is important and how intervention will impact Return to Sport and Re-injury rates

The primary goal of rehabilitation following soft tissue injuries is to ensure the athlete returns to the sport in adequate condition that mitigates the risk of re-injury within the same and other regions (Opar, 2012). Physiotherapy achieves this by allowing adequate time for biological tissue healing alongside ensuring muscle strength, endurance and power are conditioned to meet the sporting demands required. At Return to Performance (RTP) Physiotherapy we test strength and power throughout your rehabilitation process and at time of return to sport through utilising data provided by our Hawkins Dynamics force plates and dynamometers to assist in guiding management. At RTP our rehabilitation is criteria based ensuring athletes pass all stages of rehabilitation on their way to returning to the pitch/track/field/road or court.

ACL Injury Diagnosis and Management

Fri, 17 Apr 2026 02:08:53 GMT

Anterior cruciate ligament (ACL) injury is a catastrophic injury to the structural scaffold of the tibiofemoral joint (thigh and lower leg bone joint) whereby the forces tolerated by anterior cruciate ligament are exceeded resulting in break-down of the ligament tissue either partially or completely (rupture). No two ACL injuries are the same with concomitant injuries common including meniscus tear, bone marrow oedema (BMO), other collateral ligament tearing (MCL/LCL/PCL) and chondral cartilage injury (tissue covering articulating surfaces of the knee joints).

Mechanism behind injury of ACL is 70-80% of the time non-contact, whereby the individual is typically landing from a jump, pivoting or decelerating (Renstrom et al, 2008). ACL injuries resultant from contact typically occur with a blow from behind the knee causing a forward shearing force at the knee.

Despite the overwhelming research in the ACL space over the past 20 years incidence rates continue to rise with Australia’s ACL incidence rate the highest in the world (Moses and Orchard, 2012) with annual growth rate of 4-8% each year in males and 5-10% each year in females. Highest rates of ACL injury occur within those sports whereby movement patterns include frequent pivoting/cutting.

Return to sport rates post ACL injury vary significantly throughout research and are dependent on many differing variables external to the injury itself. Despite high return to sport levels post injury less than 50% return to their previous level of competitive sport and only ~63% return to there pre-injury sport (Arden et al, 2011, 2012). Statistics highlight that those returning to sport 1 in 5 will re-injure within the first 10 years with 50% of these injuries occurring within the first year alone (Shelbourne et al, 2009). 1 in 3 individuals under the age of 20 years that return to sport will sustain a second ACL injury within the first 2 years with greatest risk within the first year post operation (Nagelli and Hewitt, 2016). For every month that return to sport timelines were delayed until 9 months the rate of knee re-injury is reduced by 51% (Grindem, 2016).

Not only is allowing time for biological healing a critical piece to effective ACL rehabilitation prior to returning to sport. Also, as critical is following up with your physiotherapist to assist and guide you through the initial process of calming down the knee from a swelling and pain perspective early on post injury/surgery and regaining function including full knee movement regaining lower limb strength and returning to a normalised walking pattern. Through to returning to a fluent running style, re-gaining adequate neuromuscular control, power and agility prior to returning to sport ensuring the individual has achieved the necessary prerequisites unique to the demands of their specific sport.

Research evaluating return to sport post ACL repair at 12 months demonstrated only 23% of patients who have returned to sport met all criteria required to pass the recommended physical performance battery prior returning to sport, likely elevating and contributing the risk and level for re-injury rates (Edward et al, 2018). Post-operative rehabilitation has a significant association with greater physical function, most evident in younger patients and is a critical component to restoring physical function necessary to withstand the demands required to not only return to sport but return to the same sport at the same competitive standard. This alarming statistic raises questions regarding can re-injury rates partially be attributed to level of therapist understanding with respect to physical function qualities required to return sport or quality of education provided to patients around those conversations regarding level of physical function necessary to pass the criteria developed to lower potential re-injury rates particularly within the first 2 years upon return to sport. Furthermore, does the therapist have the necessary access to utilise technology required to effectively measure and assess such critical qualities including strength, power and movement patterns before providing clearance for return to sport.

returntoperformancephysiotherapy

Red Flags to Watch Out for When Selecting a Physiotherapist

Red Flags to Watch Out for When Selecting a Physiotherapist

﻿

Red Flag #1: No Proper Assessment Before Treatment Begins

Red Flag #2: Vague or Dismissive Explanations

Red Flag #3: Treatment That Never Changes

Red Flag #4: Passive Treatment Without Active Rehabilitation

Red Flag #5: Encouraging Indefinite Treatment Without Clear Goals

Red Flag #6: Dismissing Other Healthcare Providers

Red Flag #7: Not Registered With AHPRA

Red Flag #8: Rushing You Through Appointments

Red Flag #9: Making Overpromised Guarantees

Red Flag #10: No Focus on Your Goals

What Good Actually Looks Like

What Questions Should You Ask Your Physiotherapist During Your First Visit?

What Questions Should You Ask Your Physiotherapist During Your First Visit? ﻿

Questions About Your Diagnosis

"What do you think is causing my pain or problem?"

"Is there anything I need to rule out before we start treatment?"

"What's actually happening in my body — structurally or functionally?"

Questions About Your Treatment Plan

"What does treatment look like from here?"

"How will we know if treatment is working?"

"What should I be doing between sessions?"

"Is there anything I should avoid doing while we're treating this?"

Questions About Prognosis and Expectations

"How long does this typically take to resolve?"

"Is full recovery realistic, or is this about managing the condition?"

"What happens if this doesn't improve as expected?"

Questions About Your Specific Situation

"Have you treated this condition or type of injury before?"

"Is there anything about my lifestyle or work that I should flag with you?"

"What can I expect to feel after today's session?"

The Meta Question: Do I Feel Comfortable Here?

Ready to Book?

How to Choose the Right Physiotherapist for Your Needs

How to Choose the Right Physiotherapist for Your Needs

Start With What You Actually Need

Check Their Qualifications and Registration

Look for a Physio Who Listens

Consider the Setting and Equipment

Ask About Their Treatment Philosophy

Location and Practicality Matter More Than You Think

Don't Ignore Word-of-Mouth

Trust Your Gut in the First Session

The Bottom Line

Osgood Schlatter’s - Why my kids always complain about their sore knee

Osgood Schlatter Disease (OSD)

Acute management of Soft Tissue Injuries

Effectiveness of Acute Treatment on Return to Sport timelines

What Acute Treatment Looks Like

Why Physiotherapy is important and how intervention will impact Return to Sport and Re-injury rates

ACL Injury Diagnosis and Management

What Questions Should You Ask Your Physiotherapist During Your First Visit?