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Should I See an Exercise Physiologist or a Physiotherapist?

by Sam Donohue & Taya Harding

Should I See an Exercise Physiologist or a Physiotherapist?

Maybe you have a health condition that you’d like to manage, or an injury you need to treat, or even a work related injury or concern. You might be wondering who is the best person to see you…

The short answer is, it depends!

Whilst there is a lot of skills overlap between exercise physiology and physiotherapy, they are not the same. Physiotherapy is generally more clinical in nature, and exercise physiology is exercise and lifestyle based. But, that’s a pretty big generalization. So, for the long answer, keep reading!

Firstly, you may be wondering…

What is Exercise Physiology?

Exercise Physiologists (EPs) are university qualified allied health professionals equipped with the knowledge, skills and competencies to design, deliver and evaluate safe and effective exercise interventions for people with acute, sub-acute or chronic medical conditions, injuries or disabilities.

EPs can create exercise prescriptions or recommend certain lifestyle changes for a range of medical conditions. The range includes and is not limited to cardiovascular, metabolic, neurological, musculoskeletal, cancers, kidney, respiratory / pulmonary and mental health conditions. Essentially, EPs can treat any condition for which there is evidence that exercise can improve the client’s clinical status! The EP will assess your condition, and then work with you to effectively manage it.

So what specific conditions can an Exercise Physiologist treat?

You may have a specific medical condition that you are wanting to manage with exercise and lifestyle interventions. The list above is fairly broad, so we’d like to give you a few examples. EPs, and in particular our EP Sam, have the knowledge, skills and expertise to help manage the following conditions:

  • Arthritis
  • Back pain
  • Cancer
  • Children’s health
  • Chronic pain
  • Diabetes
  • Heart Health
  • Injury recovery
  • Mental health
  • Neuromuscular disease
  • Obesity
  • Osteoporosis
  • Prostate cancer
  • Pelvic organ prolapse
  • Bowel cancer
  • HIV
  • Solid Organ transplant
  • Dementia
  • Lung conditions
  • Falls prevention
  • MSK Disorders
  • Spinal injury

What else does an Exercise Physiologist do?

As EPs deliver services based around exercise and lifestyle interventions, they can assist you with any ailment that can be treated or managed with exercise.

Sam our EP is the leaders of PhysioWest’s hydrotherapy program! Sam is currently in the pool (in Thebarton & Parafield Gardens) 4 times a week. Sam works 1:1 with clients in the pool for water-based exercise prescriptions. Sam works with NDIS participants, clients in the Return to Work SA model, private clients for rehab or injury management, and more! Hydrotherapy is water-based exercise, designed to provide low-impact resistance with additional support – great for clients who have recently had orthopedic surgery, clients who aren’t suited to high impact exercise, and many more.

Sam also works with a lot of Return to Work SA clients. Work-related injuries are often treated with exercise-based interventions. Once an injury moves from the acute stage an exercise physiologist can step in and provide an exercise prescription to treat or manage the injury. This part of an EPs job overlaps a lot with that of a physiotherapist. That makes them an excellent allied health team, working together with clients to reach the absolute best outcomes through the sharing of their wealth of knowledge and skills.

NDIS is another category of clients that Sam sees a lot of. The EP’s role with NDIS participants is to help them reach their health and wellbeing goals as per their NDIS plans. Often this is through capacity building and improving their day to day lives. EPs take on this role where their medical improvement threshold has been reached, but there are possible improvements that can be made through exercise! EPs can help the participants in so many ways, including improving their mental health, improving their balance/strength/mobility, improving their confidence, managing their disability or condition, and so much more. All this through exercise, lifestyle adaptations and a friendly face!

Also, EPs can provide tailored exercise programs generally for weight management or general strength and conditioning goals. After all, they’re exercise experts!

If you’re thinking a physiotherapist could do the same thing… You’re almost correct, there is a lot of overlap! Exercise Physiology is an exercise and evidence based allied health profession. They have specific knowledge on medical conditions and exactly how exercise can benefit and improve the condition, which is knowledge that physiotherapists don’t necessarily have. And, physiotherapy is a little bit different.

So, how does it differ from Physiotherapy?

As mentioned above, this question can be so confusing because both physiotherapists and exercise physiologists work within a broad scope of practice and there is a lot of crossover.

Both professions require 4-year undergraduate degrees, or a 3-year degree if they wish to further their studies with a graduate diploma (for exercise physiology) or a master’s degree and/or doctorate (physiotherapy).

Both physiotherapists and exercise physiologists are recognised by Medicare, MVA insurers, RTWSA, NDIS, self insured companies and private health funds, and both professions require yearly professional development to maintain up to date accreditation.

Putting it very simply, an exercise physiologist will assess and manage your condition with exercise. Whereas a physiotherapist will assess, provide a diagnosis and treat your condition through a variety of hands-on skills (manual therapy), education and exercise. Because of this, there are some instances where you will need just one of these services, while some injuries and conditions may require assistance from both. Physiotherapists and exercise physiologists can collaboratively provide treatment for a range of conditions.

If we do say so ourselves, they are a match made in allied health heaven!

According to ESSA, who are the peak professional body and sole accrediting authority for exercise physiologists in Australia:

“Exercise physiology and physiotherapy are both recognised allied health professions. Exercise physiologists primarily treat patients using clinical exercise interventions as their main modality. There is also a strong focus on behavioural change and self-management concepts. Physiotherapists are health care professionals who assess, diagnose, treat and manage acute injury, disability and pain…”

So, what are the unique aspects of physiotherapy?

Physiotherapists work across all phases of injuries from acute, to sub-acute, to chronic.

Early intervention is key to a shorter recovery and better client outcomes. The acute phase of an injury is often associated with pain, swelling, bruising and restriction in movement and function. This is a great time to check in with your physiotherapist for assessment and commencement of intervention.

Physiotherapists deliver soft tissue mobilisation through massage, dry needling, and ultrasounds, but also at times prescribe self-massage techniques. Physios are able to deliver an injury diagnosis and prognosis, while exercise physiologists usually receive this diagnosis and then deliver the rehabilitation prognosis. Physiotherapists usually treat musculoskeletal conditions and injuries, but can also treat things like headaches, vertigo, pulmonary conditions, and more. They are usually also the first point of call for rehab after orthopedic surgeries, like total joint replacements. This is because they can prescribe exercise based rehabilitation programs, but also assess other parts of the recovery, for example swelling. Plus, they can also assist prior to orthopedic surgery, often referred to for ‘prehab’ to prep the client for surgery. The scope of physiotherapy, in terms of it being a health care profession, is more broad than exercise physiology.

What are the unique aspects of exercise physiology?

Exercise physiologists deliver instruction, education and typically specialise in providing lifestyle education and lifestyle modification techniques to support individuals with a wide range of chronic health conditions (such as those listed above) to promote improved health and wellness and decrease their risk of all-cause morbidity.

Exercise physiologists will work with you to consider the how and the why of your circumstances so that both can be addressed and help to prevent future recurrence.

Exercise physiologists can also work with you to develop individually tailored exercise plans to help you achieve your goals around losing weight or maintaining a healthy weight; or create a strength and conditioning program to take your fitness to the next level.

What does an EP session look like?

Your EP will spend a little bit of time getting to know you before diving into the nitty gritty.

An introduction, initial assessment, and thorough check of your history to define your current state of health and your exercise background. At PhysioWest, your initial appointment with an EP is 60 minutes. This is so that the assessment can be really in depth, and you have a great session to get your care started strong.

A consult also includes a physical assessment to determine some objective measures; such as your blood pressure, heart rate, body composition, exercise tolerance and muscle strength. This allows the EP to have baseline statistics to base your program around this and be able to track your improvement accurately.

Your EP will also provide education on how specific exercises can help and how it relates to your injury or condition. They will also provide education on strategies you can use to achieve your exercise, health, and wellness goals. This can include motivational techniques, exercise and lifestyle planning and ongoing support.

Finally, they will help you complete an individualised and targeted exercise session in the clinic. The exercise session helps the practitioner to create a clear and individually tailored exercise program with clearly defined goals and milestone targets based on everything else you have discussed in your session.

What does a Physiotherapy session look like?

As always, the start of an initial consultation is where we learn a little bit about you before we delve into the details.

Similar to an EP initial, your physiotherapist will discuss exactly what it is that you came in for and what it is that you’d like to achieve through your treatment with us. Your physiotherapist will address your specific concerns so that you leave without questions unanswered. Your physiotherapist will assess you to provide a diagnosis, a prognosis for recovery, and work with you on how that can be achieved. The assessment may include looking at your pain, any visible signs of injury, range of motion, strength, and other factors that are indicative of injury.

Your Physiotherapist will advise you on your problem area, injury or condition, and what stage you’re in (for example, the acute stage. They will provide education on how or why that’s the case, what the stage you’re in means, what it is that’s happening, and what the next steps are. Your physiotherapist will build a management plan for you, that details your recovery journey.

The management plan is recovery central. It is the outline of your treatment with us; your diagnosis, your prognosis, your goals and the treatment plan. The physiotherapist will provide this to you at the end of your consult.

As well as the management plan, your physiotherapist will likely provide an exercise prescription for you (if appropriate!). The exercises will be discussed in the consult so that they can be tailored for you, you know how to execute them safely, and that you understand any concerns about pain. Exercise-based interventions are the most common treatment that physiotherapists provide. As they say, motion is lotion.

Physiotherapists can also provide a range of manual therapies, including massage and dry needling. These are usually provided in conjunction with the exercise prescription, so that you leave feeling great but also stay feeling great! Some clinics also provide ultrasound as a treatment modality, but we don’t at PhysioWest. If you want to know why, we have a recent blog dedicated to this! We recommend checking it out.

The physiotherapist may also record some objective measures, including your range of motion, strength, any impairments or limitations, and use these as a baseline to track your improvement.

We hope that answers the question of whether you pick an EP or a physiotherapist!

Essentially, if you’ve hurt your ankle at netball or have just had a total knee replacement, you should see a physiotherapist. If you’ve got a chronic condition like diabetes and you’d like some advice on how to manage it, the EP is the one for you. Also, because physiotherapists and EPs work closely together, they can cross-refer if they think you’d be better suited to the other practitioner.

Don’t stress too much though…

If you’re still not sure, give our client services team a call on 8352 3582! We can talk through your circumstances and what you’d like to achieve and provide some direction. Plus, we can advise on ways you can access these services. We can then book in with the EP or the physiotherapist on the spot!

Plus, we have some exciting news! We have some new therapists joining us very soon… stay tuned!

 

We would love to see you in the clinic. Give us a call, or use the link in the top right hand corner or below to book online!

 

Thanks for reading!

 

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