Comprehensive Physiotherapy Care at Health+

Can you start by summarizing what physiotherapy services H+ provides to clients? What can physiotherapy care include?
Physiotherapy is a medical discipline that deals with the prevention, diagnosis and treatment of musculoskeletal disorders. It has a wide range of applications from prevention to addressing functional musculoskeletal problems such as joint, tendon, muscle or spinal pain, to restoring function after injury or surgery. It is useful wherever the musculoskeletal system is overloaded by asymmetrical workload, intense sports, etc. As part of our physiotherapy care, we offer clients diagnosis and individual physiotherapy by university-educated physiotherapists with more time given for therapy. On the basis of an initial interview, which is used to establish the client's medical history, and a subsequent examination, the physiotherapist determines a so-called physiotherapy plan, which is implemented using movement, manual or physical therapy. We work closely with our doctors of all specialties, most often personal physicians, neurologists, orthopedists and other necessary specialists who may recommend physiotherapy as part of a comprehensive treatment to clients. We provide care to all ages from birth to the elderly.

What health problems do clients see you for most often? Does it differ in any way for children, adolescents, adults and seniors?
‍The most common reason people seek the help of a physiotherapist is musculoskeletal pain and movement limitations. A high percentage of our clients are people with back or neck pain (working age people and children), shoulder or weight-bearing joints such as hip and knee joints. In older age, arthritis and mobility limitations are more common, as are coordination and balance problems. Exercises aimed at improving muscle coordination and balance are important in preventing falls in the elderly. In addition, there is a clear parallel between physical activity and good mental fitness. Health+ clients include many active athletes who occasionally present with tendon or muscle strain after a higher workload or due to prolonged overuse from  sports that load the body asymmetrically without appropriate movement compensation. Back and neck pain is also often caused by long-term overloading of the musculoskeletal system with an unbalanced workload or by sitting for long periods in an inappropriate position with poor ergonomic support. This is something that many have experienced thanks to working from home during the pandemic. Physiotherapy helps to restore the limited function of the musculoskeletal system not only in these cases, but also after an injury or surgery.

What about physiotherapy for children?
‍Physiotherapy for children and adolescents is quite specific. In early childhood we most often deal with the quality of motor development. Based on observation and examination of the child's motor expression, the physiotherapist then suggests to the parents an appropriate method of movement stimulation, either through play or special techniques. Especially for young children, the daily therapy is in the hands of the parents, the physiotherapist trains the parents and then corrects them. In preschool and school-age children, we most often encounter faulty posture, which is becoming a major problem in modern society. One of the causes is the lack of dynamic load. Physiotherapy can also be part of the preparation for pregnancy and childbirth, as it will greatly help adjusting to the postpartum period.

Can clients make an appointment for physiotherapy on their own, or do they have to be referred by their personal physician, rehabilitation doctor, neurologist or other specialist?
It is advisable for a client coming for physiotherapy for the first time to be seen by a physiotherapist or a physician with a specialty, most often in neurology, orthopedics, pediatrics or gynecology. Physiotherapy may also be recommended by a personal physician as part of the treatment approach. A physiotherapist is a specialist trained in the diagnosis and treatment of musculoskeletal disorders. The doctor's previous examination will rule out other possible sources of pain not primarily related to the musculoskeletal system and will alert the physiotherapist to any risks or limits that need to be respected when providing physiotherapy. The personal or specialist physician may also take advantage of the consultation to refer the client to a rehabilitation physician who is deeply knowledgeable about musculoskeletal disorders and how to treat them due to his or her certification. He or she will then be able to prescribe further complementary examinations, targeted physiotherapy procedures, including physical therapy, or, in addition to outpatient therapy, send the client for a rehabilitation stay at an inpatient or spa facility. If the client only wants to undergo a physiotherapy consultation, e.g. finding a suitable exercise regime, compensation in sports or ergonomics at work, then no prior medical examination is necessary.

In which cases should people definitely consider a visit for physiotherapy?
For children, certainly in the case of delayed or uneven motor development, asymmetry, faulty posture, scoliosis or other spinal deformities. Parents whose children have these types of problems will certainly be advised to see a pediatrician. In adolescents and athletes, tendon or joint overload from rapid growth or excessive physical stress often results in conditions such as tendon pain, ankle joint distortion, sprained ankles, foot arch disorders, and breathing difficulties. Generally speaking, if a person is suffering from intense or prolonged musculoskeletal pain, they should definitely consult their doctor, who will examine them and recommend physiotherapy if necessary. Women who are pregnant should also consider seeing a physiotherapist, as physiotherapy can help with back pain, but also in preparation for childbirth, postnatal pelvic floor physiotherapy and so on. Physiotherapy care also helps to alleviate health problems associated with menopause – osteoporosis, conditions after gynecological surgery, pelvic floor muscle dysfunction, for example, milder degrees of incontinence or after prostate surgery in men. In certain cases, physiotherapy according to the method of Mrs. Ludmila Mojžíšová can help with difficulties in getting pregnant.

What is the first contact between the physiotherapist and the client like? Is there any diagnosis of his or her difficulties? Can you specify what form it takes?At the beginning of the therapy, the physiotherapist performs a general or targeted examination of the musculoskeletal system, including a targeted history of the client. The examination includes standing and gait tests, spinal and joint mobility, muscle strength, shortened and weakened muscle groups, basic movement patterns, and other targeted functional tests as appropriate. The aim is to help the client find the potential sources of their difficulties. Based on this examination, individual physiotherapy is then carried out. In order to be able to evaluate the functions well, the physiotherapist needs to see and palpate, i.e. examine the body part in question by touch, so the initial examination takes place with the client undressed to their underwear. It is a good idea for the client to take this into account and choose some in which he or she feels comfortable.

What physiotherapy methods and techniques do physiotherapists use? And can you say which ones are usually among the most effective for the most common problems?
‍There are a number of approaches and methods used in individual physiotherapy, which may vary slightly from therapist to therapist, including the amount of postgraduate study and training they have had. Because most clients come in with pain or some sort of movement limitation, the most commonly used techniques are manual techniques – mobilization, soft techniques on the muscles, skin, fascia (muscle sheaths), and others – and some of the many physiotherapy methods – for example, following Brügger, McKenzie, Mojžíšová, Vojta, dynamic neuromuscular stabilization inline with Kolář, ACT and sensorimotor exercises on unstable surfaces such as balancing aids, stretches or foam pads. The choice of approach is made by the physiotherapist on the basis of a previous assessment of the suitability for the particular client and his or her difficulties. The therapy also includes the recommendation of compensatory exercises, appropriate physical activities or ergonomic advice, such as modification of the working environment. The most effective approach is one that is easy for the individual client to understand and to be able to continue at home on the basis of the recommendations, as the success of physiotherapy depends largely on the client's active approach and regular implementation of the recommended exercises.

For clients who do not have personal experience with physiotherapy at Health+, can you explain more about the facilities and resources available for physiotherapy?
‍The physiotherapy takes place in the beautiful surroundings of the reconstructed historical Ringhoffer Villa, where we already have 3 physiotherapy rooms equipped with a recliner, a mat and various exercise aids such as balls, therabands (rubber bands with elastic resistance), unstable pads for balance and stability training and other aids. However, the most commonly used tools are the physiotherapist’s hands.

How many physiotherapists currently care for the clinic's clients?
‍Currently there are 7 physiotherapists working at the clinic and, in terms of prevention and increased options, it is also possible to use the services of the very experienced and professionally trained masseur Mr. Pavel Straka. In cooperation with the doctors and reception, we try to make sure that an appointment for physiotherapy is offered at the earliest possible date. We are actively working to reduce the waiting times by, for example, expanding the team of physiotherapists and introducing group exercises.

Does physiotherapy only make sense in the case of acute or chronic problems, or also as a preventive measure to maintain musculoskeletal health in people who do not have acute problems?
‍ in other fields of medicine, it is always better to prevent problems. In physiotherapy, function shapes the organ (structure). If I overload the hip joint, for example, for a long time, first there is a restriction of movement, pain, and later, if not corrected, there is a change at the level of the structure – for example, the development of arthrosis. This is why, for example, compensation for asymmetrical sports or workload is important. Here, the physiotherapist can detect any risks based on his examination and suggest suitable compensation, adjust the position at work, etc.

How regularly should I have physiotherapy?
‍In the case of acute problems, the frequency of physiotherapy may be higher, once or twice a week, or even more often for some disorders. Once a suitable self-therapy has been found that the client can do at home and is actively involved in improving the condition, the frequency of office visits may be reduced, depending on the progress of the condition and the rate of improvement of the disorder.

Thank you for the interview.