DIY (do-it-yourself) is such a popular thing these days: DIY home improvements, DIY fixing your car, DIY home crafts. With a powerful search engine like Google and information trading sites like Wikipedia or Youtube, you can learn almost anything out there on the comfort of your couch. It’s a majorly satisfying feeling, and especially with the economic crisis in current 2023, it could save you money! What if you could DIY physiotherapy? I’ll paint you a picture of what this might look like.
What Might DIY Physiotherapy Look Like?
DIY home improvements is quite obvious – as the DIYer, you would work on the home doing painting, decorating, furniture building. DIY physiotherapy, however, sounds a bit bizarre at first thought. Like a house working to improve itself, it makes one wonder whether it can be done. The difference between a house and a human is that a human has a mind and is capable of acting on its thoughts. Self-help would be a more similar concept to DIY physio. Self-help defined by Merriam-Webster is “the action or process of bettering oneself or overcoming one's problems without the aid of others”. DIY physio would be self-help towards one’s musculoskeletal (MSK) health.
Difference Between Staying Active and DIY Physiotherapy
This is different from staying active such as starting a sport, going out exercising, going to the gym, learning yoga and pilates; all which is self-help and contributes to improving musculoskeletal health. It can certainly contain these steps; however, DIY physio would have a wider and deeper understanding of musculoskeletal health. To make an analogy, the difference between staying active and DIY physio would be like the difference between someone driving a car, and someone doing DIY servicing on their car.
Here I’ve drawn a diagram which may help understand more about the role of DIY physiotherapy:
Initially I had written “injury” rather than “MSK condition”. The difference may seem subtle however injury wouldn’t encompass conditions such as postural pain, chronic pain – major areas within MSK health which also apply in this situation. All these four categories in the diagram above ultimately lead to a full circle of properly looking after one's MSK health, from preventing the condition, to knowing how to manage and treat themselves when they have an MSK condition, to understanding how to return to activities/sports, and then preventing themselves from sustaining another MSK condition.
There would be different levels of DIY. Basic DIY physio begins with staying active, participating in sports, understanding basic RICE (rest, ice, compression, elevation). Taking the next step into the intermediate and advanced DIY would be understanding proper movement techniques, structuring training programs, setting up a proper work place, and following correct behavioural patterns within the work place or at home.
A Repackaged Concept
You can see that for every person, this already exists to some degree. Someone’s probably thinking “isn’t this just called looking after yourself?”. Yes. Yes, it is. However, due to the fact that there is on average 3 out of 10 people with musculoskeletal issues at one given time (see link here), and that patient education is central to physiotherapy consultation (see link here for example of patient education importance), more can be done to boost people’s ability to look after their own MSK health.
In the same way that everyone looks after their car to some degree – from filling up petrol, changing the windscreen wipers to troubleshooting engine issues or changing the clutch; everyone looks after their body to some degree. DIY physiotherapy is to emphasize becoming more advanced in looking after MSK health, taking that next step to go from basic RICE injury management to knowing the MSK condition, or proper rehabilitation regimes. By creating this idea of DIY physiotherapy, we can categorize different areas DIYers must know to achieve the next level.
Limits to DIY Physiotherapy
“You don’t know what you don’t know” – Socrates and Confucius
Socrates and Confucius tells us of the limitations for any DIYer. One of the main problems with DIY is that you occasionally have a self-proclaimed expert arising from DIY, spouting confidently about something that they know and have extensively researched. It’s vitally important within healthcare to have a broad medical understanding and to know the boundaries of your knowledge. Being overly confident in managing and treating certain conditions is a main pitfall. As a professional physiotherapist, much of our knowledge and training is to screen out for issues outside of certain conditions and knowing when to refer up to an orthopaedic surgeon or on to another specialty.
“If all you have is a hammer, everything looks like a nail” – Abraham Maslow
Continuing with quotes, here Abraham Maslow tells us of how limited knowledge can skew a person’s perception into thinking that all issues connect to one answer. This can happen from the professional to beginner DIYer, however, for the DIYer there is no accreditation and strict syllabus to ensure adequate understanding. The danger lies in the way that society gives influential power to those who can use social media well. Ideas become overwhelmingly popular and become the root of all issues. Such examples would be the barefoot running trend, spinal misalignment, typical manual handling training or weak gluteals. It’s not that these issues cannot be causes, it’s that when people popularize a root cause, it becomes the ultimate fix-it hammer. MSK conditions are then seen through the lenses of these ultimate fix-it hammers and are mistreated due to this.
Benefits of DIY physiotherapy
Other than the benefit of feeling satisfied and accomplished as with any other DIY task, along with saving money on medical fees, the benefit of DIY physio is that you look after yourself better and you are able to help look after others better.
· Take Control of Your Body – Not being in control and being in the unknown is a daunting thing. Being a better DIY physio will allow you to be in the know. You will prevent episodes of neck postural pain in front of the computer, rehabilitate yourself properly after an ankle injury, understand how to manage that debilitating sciatica.
· Saving Money on Medical Fees – Even in private healthcare, much of a consultation is on discussion and education. Becoming a more advanced DIY physio will fast track that discussion as you are in the know. Also, it prevents you from accessing services unnecessarily and only using them when you truly are at the limit of your knowledge.
· Help Look After Others – Your child has twisted their ankle. Do you rush them to hospital, do they need a scan, do they need crutches, can you put ice on there? Or your father has severe joint pain and can’t get out of the house. Should he rest in bed, should he use hot or cold, what exercises may benefit him? Progressing in your DIY physio knowledge allows you to help those loved ones around you.
A Syllabus for DIY Physiotherapist
Here I draw up a possible syllabus of what a DIY physio would need to know:
1. Anatomy and Physiology
These two areas allow the DIYer to become familiar in how structures work within the body and how it interconnects with one another. To start with, there doesn’t need to be much depth such as naming of muscles, but rather to know broadly the existence of such structures. Without this basic foundation, it’s difficult to build up down this list.
2. Pathology and Conditions
Pathology refers to causes/effects of diseases, and conditions refers to cases not related to a disease. When any issue arises, the DIYer will be able to understand how the function has derailed from normal physiology. Again, it is more important to understand broadly the types of pathology and conditions that can arise, before going in depth with each one.
3. Biomechanics and Posture
Mechanics refers to the branch of physical science dealing with motion and forces producing motion, biomechanics is mechanics within the structure of living organisms and in our DIY physio case, human bodies. Understanding biomechanics and posture allows the DIYer to have insight for why some conditions appear in certain movements or postures, and so deal with the root cause for these issues.
4. Active Treatment
There are 2 types of treatment – active and passive treatment. Active treatment refers to the person who is receiving the treatment actively participating in it through their body. This mainly refers to exercise rehabilitation but can also include behaviour modification, mindfulness strategies, and relaxation techniques.
5. Passive Treatment
Passive treatment is having someone or something else to work on you, the person receiving treatment. This could mean seeing someone else to work on you such as massage, joint manipulation, stretch therapy; or it could be you using something on yourself such as self-massage, using hot/cold therapy, taking medication, using a TENS machine.
6. Evidence-Based Practice
With cutting edge scientific research being pushed out constantly, it’s important for the DIY physio to keep up to date with what is out there. There is an understandable restriction to this though. Even as a professional physiotherapist, it’s difficult to have the time to research while working. What is essentially important is to acknowledge that there is constant new research and to know how to research when someone makes a claim about new treatment/investigative techniques.
Put Physios Out of Business?
My wife read up to this point and asked me why I was writing this. Just like how technological advances has brought in automation, resulting in less factory jobs and less labor-intensive jobs; there would be a possibility that people advancing on self-management in MSK healthcare would result in people avoid seeing physiotherapists and just to do it themselves. I don’t believe it will happen this way. As we see much more home improvement DIY, we still see many people accessing tradesmen such as painters, decorators, carpenters, electricians, and plumbers. How come? The reason is because if you want a high-quality job, or if the issue is out of your depth, you would still access an expert.
As mentioned under a section above titled “Limits to DIY Physiotherapy”, there are important limitations to know as a DIY physiotherapist, or even a professional physiotherapist, and so when the limitation is reached, then the DIYer should escalate the issue to the professional physiotherapist. If DIY physio was more common and more advanced, professional physiotherapists would be seeing more interesting complex clients, wouldn’t need to run through basic anatomy and physiology education but instead go through intriguing new scientific research, and would be providing specialized passive hands-on treatments which you can’t DIY. It would overall improve the quality of physiotherapy for wherever this concept takes hold of as no one would want a lower quality if they could DIY themselves.
Develop Yourself as a DIY Physio Now
Here on the Abbey Mobile Physio website, we plan on releasing content to teach the average Joe Bloggs how to improve themselves from a basic DIY physio to an advanced DIYer. In the meantime, we encourage you to take the driver’s seat for your MSK health: understand more about how your body works, be interested in whatever MSK condition you or your loved one’s encounter, research about what the best treatment is for your condition, take proactive steps to prevent injuries or conditions from happening, and ask your professional physiotherapist for advice on how you can DIY physio yourself better... If you’re not with any professional physio and you’re around the Abingdon-on-Thames area, reach out to Abbey Mobile Physio. We can help you.
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