What’s the difference between a Physiotherapist and an Exercise Physiologist?

What’s the difference between a Physiotherapist and an Exercise Physiologist?

As Accredited Exercise Physiologists, we are commonly mistaken for physiotherapists, and are frequently asked how our profession differs from that of a Physio.

This enquiry can often come from patients, friends, family members and even other health professionals.

Whilst both health professionals have a common end goal when it comes to treating patients, we do however go about this is different ways.

We aim to provide high-quality treatment to enhance optimal physiological functioning.

Distinguishing between an Exercise Physiologist and Physiotherapist can be rather difficult.

Both professions can work within a varied scope of practice, and therefore it is only natural that this confusion exists.

In saying this, we thought we would try and tackle it here in this blog and try to provide clarity to those who are still puzzled on the situation.

So how do we tell the difference?

Let’s start off by comparing the two. Both professions undertake 4 years of university training, both theoretical and practical, studying subjects such as anatomy, physiology and biomechanics to name a few.

Both are recognised by Medicare, TAC, WorkCover and private health funds, and require yearly professional development to maintain up to date accreditation.

However, when asked how Exercise Physiologists differ from Physiotherapists, we often refer to the different stages of the injury cycle in order to illustrate at which point each health professional can provide optimal treatment for recovery.

Let’s use the example of a simple left ankle joint sprain.

Injury Cycle – Acute Phase

Immediately post injury (this is often called the ‘acute phase’ of the injury), it is recommended to visit a Physiotherapist in order to assist in controlling inflammation of the joint and pain.

At this stage, Physiotherapists are also able to provide a diagnosis of the injury, provide manual therapy, and if needed, provide temporary mobility aids such as a splint or crutch.


Injury Cycle – Recovery Phase

The next phase of rehabilitation, which usually occurs at 3 to 4 weeks post injury, is when an Exercise Physiologist will step in and provide treatment in order to introduce gentle exercises to regain range of movement, including mobilisation of soft tissue structures, and restore joint mobility and strength to optimise function.

All exercises prescribed by the Exercise Physiologist are made to achieve each individual’s activities of daily living and rehabilitation or performance goals.

So why the difference between a Physio and an EP?

Exercise Physiology as a health profession, has only been around for a relatively short period of time.

Due to this, a huge part of our profession is to provide education to both the members of the public and fellow health practitioners, regarding what our exact role is as rehabilitation specialists.

To distinguish between the two professions, the most common differences can include:

  • Exercise Physiologists delivering prescription and education on trigger point therapy and self-massage techniques, using equipment such as foam rollers and trigger point balls.
  • Physiotherapists, on the other hand, can primarily deliver soft tissue mobilisation through massage, acupuncture, dry needling and ultrasounds, but can also prescribe self-massage techniques.
  • Physiotherapists are able to deliver the injury diagnosis and prognosis, whereas Exercise Physiologists receive the injury diagnosis and deliver the rehabilitation prognosis.
  • Exercise Physiologists specialise in providing lifestyle education and lifestyle modification techniques to support those with a wide range of chronic health conditions (including cancer, diabetes, respiratory conditions, mental health conditions, and cardiac related conditions) to promote improved health and wellness and decrease risk of all-cause morbidity.
  • Physiotherapists will typically specialise in the acute phase of an injury, and can often also deliver long-term rehabilitation and health monitoring.

Do I need a Physiotherapist?

Whilst what is mentioned above may seem very technical and confusing to you, using the below checklists are a great way to decide which health professional is best for you, or your patient (if you are a referring GP):

  • Do you have pain that is new, unexpected, or not yet diagnosed?
  • Or you have an acute sports injury, or have you recently undergone orthopaedic surgery?
  • Do you require hands-on treatment for symptomatic relief such as acupuncture, manipulation or massage?

If you have answered yes to any of the above questions, than a Physiotherapist may be for you!

During a typical consultation, the following will be undertaken by the Physiotherapist:

  • A thorough patient history, followed by an assessment and diagnosis of condition
  • Discussion of expectations and desired outcomes (goals) of treatment
  • Education on condition
  • Development of a clear treatment and prevention plan
  • Utilisation of manual therapy techniques to provide symptomatic relief (if needed)
  • Prescription of home exercises and other interventions (such as triggering or foam rolling) and ongoing pain education
  • Constant liaising with GPs or specialists to ensure collaborative approach to the management of your injury or pain

Or do I need an Exercise Physiologist?

Alternatively, if you have answered yes to any of the following questions:

  • Are you recovering from an injury, or have a prior injury that you do not want to exacerbate, however wish to get fit and healthy?
  • Do you have a chronic health condition (such as diabetes, hypertension, high cholesterol, asthma, obesity, osteoporosis etc.) which exercise could assist with?
  • If you have goals around losing weight or maintaining a healthy weight?
  • Do you seek a specifically tailored and prescribed exercise program that will meet your health and wellness needs?

Then an Exercise Physiologist is definitely for you!

A typical session with an Exercise Physiologist may include the following:

  • Introduction and initial assessment and thorough history to define current state of health and exercise background
  • Physical assessment to determine objective measures (such as blood pressure, heart rate, body composition, exercise tolerance and muscle strength)
  • Education on how exercise can help and how it relates to your presentation/condition
  • Completion of a individualised and targeted exercise session in the clinic
  • Education on strategies to achieve you exercise, health and wellness goals including motivational techniques, exercise and lifestyle planning and ongoing support
  • A clear and individually tailored exercise program with clear defined goals and milestone targets
  • Ongoing communication with other caregivers such as GPs, specialists or insurance case managers to ensure collaborative approach to your treatment and management

And for our wonderful GP friends…

below is a simple flowchart which you can follow if you are looking to refer your patients on to receiving further health treatment, however are unsure as to which health professional would be ideal.

Reference: Diagram created by Exact Physiology Accredited Exercise Physiologist

A very simple way to think of the difference between the two is that physiotherapists provide “hands on” or passive treatment, (joint manipulation, massage and acupuncture), whereas Exercise Physiologists provide a “hands off” treatment or active treatment through specific clinical exercise programs.

Physiotherapist or Exercise Physiologist – A Case Study

Below is a case study that details the types of patients that are suitable to seeking treatment from each health professional and at which stage of the treatment journey a Physiotherapist and Exercise Physiologist would best suit:

NOTE: Case Study created by Exact Physiology Accredited Exercise Physiologist

Situation

Sam is a 43 year old male with non-specific chronic low back pain which developed at work approximately 5 months ago.

Following injury, Sam has not returned to work as a greenkeeper and has significantly decreased his daily physical activity levels as a result of the pain. Sam reports no previous history of back pain.

He is overweight and takes medication for his high blood pressure.

Injury Cycle – Acute Phase

Roughly 1 week after the pain commenced, Sam sought physiotherapy treatment in the form of massage and acupuncture, as well as acute injury rehabilitation exercises.

Following this, Sam reported some improvements in pain and an increase in his range of motion.

Injury Cycle – Recovery Phase

Sam was then referred to an Exercise Physiologist by his GP to improve his physical activity levels and functional tolerance, in conjunction to assisting with pain reduction.

Imaging of the lumbar spine showed mild disc degeneration at L1-L3 and moderate degeneration at L4-L5.

Disc protrusion was noted at L4-L5 and grade 1 spondylolisthesis. This was diagnosed and confirmed by both the GP and physiotherapist.

Rehabilitation Goals

During his initial assessment with the Exercise Physiologist, Sam’s short term rehabilitation goals were:

  • Be able to lift and carry 10 kg without pain (i.e. complete the grocery shopping)
  • Get back to mowing the lawn
  • Get back to his assistant coach role for his son’s soccer team (and be capable of basic ball skills and activities requiring trunk bending and rotation)
  • Return to pre-injury work hours which is 35 hours per week on suitable duties (lifting to 10 kg)

Following the initial assessment, Sam engaged in a combination of both supervised and self-managed exercise twice per week for 12 weeks at an Exercise Physiology clinic.

Sam was also prescribed an adjunct home exercise program to complete outside of the sessions.

All exercises included were functional and work related and aimed at further increasing Sam’s range of motion and strength in his core, gluteal and lower back region, which are all integral for adequate spinal stability and support.

Aerobic exercise was then introduced into the sessions to focus on increasing Sam’s exercise tolerance and fitness in order to get back to doing his activities of daily living without fatigue.

Making Progress with the EP

At the end of the 12 week treatment period, the same measures were taken again that were previously taken in the first initial assessment. The following improvements were found:

  • Reduced pain intensity (initial assessment 6/10, final assessment 2/10)
  • Improved lifting ability (initial assessment 10RM floor to waist lift: 0 kg, final assessment: 8 kg)
  • Improved aerobic capacity (6-minute walk test, initial assessment: 200m, final assessment: 660m)

As you can see in the example case study above, both Physiotherapists and Exercise Physiologist have the same end goal in terms of rehabilitation for patients, however are each individually integral at different stages of injury and pain. Working together, both health professionals are able to provide optimal treatment for the patient.

In Conclusion

At the end of the day, there is a degree of overlap between both professions as they aid in treating many different conditions and aspect of health and wellbeing. The take home message here is that if you are in the acute stages of rehabilitation than a Physiotherapist may be the right person to seek treatment form. However, if you are in the sub-acute and recovery or chronic stage of rehabilitation than receiving treatment from an Exercise Physiologist for a specific and individually tailored exercise program is what you need.

For further information regarding how an Accredited Exercise Physiologist can help you contact us at Exact Physiology on <a href= “tel:1300 323 210”>1300 323 210</a>

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