Now that you know what to expect during a Physiotherapy Initial Visit, you may be wondering what physiotherapy actually entails.

Depending on your condition, your goals and your preferences, the physiotherapist will include a combination of the following components.


The primary component of any physiotherapy is education. The physiotherapist will educate you about your conditions, the relevant anatomy and physiology relating to your condition, the proposed treatments and what to expect. The education is an on-going process, the physiotherapist will inform you about your progress, recommendations and different techniques used. The physiotherapist will answer any questions you may have along the way.

Manual Therapies

The physiotherapist has learned many hands-on skills and techniques over the course of their schooling and practice. Depending on your needs, manual therapies will be adapted to you. A few common manual therapies include:

Soft Tissue Therapy – Soft Tissue Therapy is a form of manipulation of the body’s soft tissues, muscles, fascia, tendons, ligaments and other tissues. Working on these soft tissues helps decrease tension. Soft tissue therapy can be deep or more superficial, include more or less of various techniques and patterns depending on your needs or preferences.

Trigger Point Therapy – A “Trigger Point” is the feeling of a tight ball, knot or band within a muscle. Trigger Point Therapy is the technique of applying a more prolonged deep pressure on these trigger points in order for them to release. When the pressure is released, there is increased blood flow to the area and gradual relaxation of the muscle or tendon. This will release the trigger points and help with the overall healing process.

Myofascial Release Therapy – The myofascia is the dense tissue that surrounds and covers all the muscles in the body. Myofascial release therapy relaxes the myofascia around the muscles and the joints. This type of therapy is more gentle – by applying a general stretching pressure to the myofascial soft tissues, the structures can then relax, the blood flow and lymphatic circulation is increased.

Friction – Friction is a technique where the physiotherapist uses the fingertips across a tendon, muscle, ligament or scar tissue itself. Friction is usually used in the treatment of tendinopathy, muscle strains, ligaments sprains and scar healing. Friction prevents or destroys scar tissue and helps with healing.

Mobilizations – Physiotherapists have been trained to move the joints with specific techniques in order to decrease pain and increase joint mobility.

Manipulation – Physiotherapists have been taught special skills in advanced courses to manipulate the joints with manual impulse, a “thrust” if indicated.


Physiotherapists are significantly trained in the prescription of exercises. Their extensive knowledge of anatomy and physiology of physical activity and exercises enables them to develop appropriate exercise programs specifically for you, your injury and fitness level. These can include the following:

  • Self-Assisted Exercises to increase movement,
  • Active Exercises,
  • Resisted Exercises,
  • Stretching,
  • Strengthening and
  • Proprioception

The physiotherapist may suggest various exercise tools, such as:

  • Elastic bands,
  • Pulley,
  • Weights,
  • Exercise balls and
  • Wobble board/Bosu Ball.


Physiotherapists have been trained to use a wide variety of modalities to assist them in treating their patients. Modalities are different machines that are designed to help patients heal in various ways: relaxing the muscles, decreasing swelling and inflammation, strengthening the muscles, etc.

Some of the most commonly used modalities are listed below.

Heat – Hot packs are often used to relax tight muscles or tendons. By decreasing muscles tension and spasms – there is less pain. The vasodilation of the blood vessels also increases circulation in the affected area, which is beneficial for healing and also soothing, notably for arthritic-type pain.

Cold – Cold packs are usually used to decrease acute pain and decrease swelling. The vasoconstriction of the blood vessels in the area brings the swelling or inflammatory process down and numbs the pain.

Ultrasound – Therapeutic ultrasound uses high or low-frequency sound waves that are transmitted to soft tissues in the area of concern. The deep vibration promotes tissue relaxation. It also causes vasodilation which can increase circulation in the area, decreasing inflammation and help with the healing process. A warming effect can also be added, amplifying these healing effects.

IFC (Interferential Current) or TENS (Transcutaneous Electrical Nerve Stimulation) – IFC and TENS are electrical stimulation used most commonly to decrease pain. Electrodes are applied to the affected area. When the machine is turned on, an electrical current is sent through the electrodes, causing a tingling sensation in the underlying soft tissues. This current affects the pain signal from the affected structures to the surrounding nerve endings – and therefore there is less pain.

EMS (Electrical Muscle Stimulation) – This little machine also uses electrical current. However, in this instance, the current is used to cause a specific muscle, or specific muscle fibers to contract. The electrodes are positioned in a specific manner to recruit the appropriate muscle/muscles fibers. This assists the physiotherapist in re-training your muscles to work properly, to increase strength and also promotes healing by increasing blood supply to the area.

Depending on the additional courses and experience of the physiotherapist, there are many other techniques that can be added. This only highlights a few main options.

Some treatments are more comfortable than others, make sure you tell the physiotherapist what you are experiencing during and after the session. This will guide the physiotherapist to find the right combination of techniques for you! Think you are ready to see a physiotherapist and live in the Ottawa area? Click here to book!

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