Musculoskeletal Therapy

Patients with MSDs are the largest patient population group treated by physiotherapists. In 2010/11 in England, physiotherapy outpatient services managed 1.9 million adults with a first appointment and 4.8 million follow up appointments for MSDs.  Rapid access to musculoskeletal physiotherapists can reduce the amount of time people are sick and is vital in preventing a new acute problem becoming chronic and long lasting. Physiotherapists have pioneered innovative ways of providing speedy and appropriate access within existing services

Musculoskeletal physiotherapists support self-management.  Physiotherapists provide nationally or locally produced patient information booklets. GPs and other referrers should ask local physiotherapy services about self-management tools which can be provided for suitable patients in primary care. Providing self-management resources at an early stage can help avoid the need for referral to secondary care with its associated higher costs.

What is Orthotics / Podiatry?

Musculoskeletal biomechanics is an important component of orthotics/ podiatry practice and links with other areas of  practice such as patients with diabetes, rheumatoid and osteo arthritis often involving multi and interdisciplinary work across primary, secondary and tertiary care. This collaboration can extend to hospital prosthetics and orthotics in surgical appliance and therapeutic footwear provision within secondary care.

The focus is on patients with a range of lower limb conditions and specialises at indentifying and addressing foot and ankle related conditions that impact upon patient’s daily lives often with a result of pain and discomfort. Many podiatry patients present with pain caused by biomechanical problems which can involve the foot, knee, hip and lower back, affecting gait. These symptoms are often part of a multi-pathological problem exacerbated by diseases such as the many forms of arthropathies and diabetes. The most cost effective and appropriate intervention to treat and prevent these symptoms is by the provision of foot orthoses, which modify or correct the biomechanical problem. Many types of foot orthoses can be provided by podiatrists according to patient needs and the presenting condition. Foot orthoses can range from a simple heel raise or cushioning insoles through to complex bespoke devices, which are made to prescription to alleviate symptoms or provide function realignment and change of gait.

What is osteopathy?

Osteopathy is a system of diagnosis and treatment for a wide range of medical conditions.  It works with the structure and function of the body, and is based on the principle that the well-being of an individual depends on the skeleton, muscles, ligaments and connective tissues functioning smoothly together.
To an osteopath, for your body to work well, its structure must also work well.  So osteopaths work to restore your body to a state of balance, where possible without the use of drugs or surgery.  Osteopaths use touch, physical manipulation, stretching and massage to increase the mobility of joints, to relieve muscle tension, to enhance the blood and nerve supply to tissues, and to help your body’s own healing mechanisms.  They may also provide advice on posture and exercise to aid recovery, promote health and prevent symptoms recurring.


Rehabilitation is about enabling and supporting individuals to recover or adjust, to achieve their full potential and to live as full and active lives as possible.

Rehab should start as soon as possible to speed recovery. Research shows it can improve your mobility and activity levels, shorten the amount of time you need to stay in hospital or off work and greatly improve the quality of your life
If you require physiotherapy as part of your rehab, you and your physiotherapist will work together to:

  • assess the nature and extent of your problems
  • set goals with you, based on what is most important to you
  • provide treatment, support and advice
  • regularly evaluate how you are progressing

The general aim is to improve your strength and mobility and to find ways around any problems. For example, if you have had a fall, your physiotherapist may recommend some equipment to assist you with walking and an exercise programme to improve your balance and strength. 

How can I help myself?

The rehab team will work with you on what is really important to you, so keep them up to date with how you are feeling. You will have exercises to practice by yourself or with friends or family, so do your best to stick with your programme.
If you have any problems with the programme, talk to a member of the team. Rehabilitation can be hard work, so allow for some set-backs as well as progress and chart your successes. Work with your team to get back to the things you enjoy.

Top tips for general rehabilitation

  • Plan short-term goals as well as your final target for your rehab
  • Follow your rehab programme and pace your activities as you recover
  • Share your targets and your set-backs with family and friends to keep your motivation going
  • Regularly review progress and targets with your physiotherapist to maintain realistic progress plans