A DAY IN THE LIFE OF A PHYSIO
I stroll in through the front door at 9:15am. I was on school drop off today - so I feel in extra need of a coffee and am again grateful for the flexibility that this job and sweet bosses allow.
The greetings from the gals at front desk are always warm and allow me to have a moan if it’s been a tough morning. I log into our Online Diary and Notes system and scan through the day whilst plugging my coffee order into the machine (potentially the most well-loved piece of equipment in the building).
I re-read notes to remind myself where I am up to with follow up clients and check any emails that have been flagged for me.
I smash half my coffee - it could be a while before I get back to it!
Physiotherapist Claire Hepperlin ↗
Morning Session: Tailored Treatment for Tennis Elbow
My first client is a follow up appointment. She has tennis elbow from working as a Baker. She is being treated under Workers Compensation so has been referred either by her workplace or her GP.
Treatment involves catching up on how things are going and tailoring treatment accordingly. It is her second session and unfortunately, she is no better. We decide together to try a brace and maybe some dry needling this time - massage and joint mobilisations don't seem to have changed anything despite her doing her exercises that I prescribed her (amazed as she has been doing them properly!).
WORKERS COMPENSATION
“The NSW Workers Compensation Scheme supports people injured in the workplace, helps employers get people back to work and supervises insurers.” Read more
TENNIS ELBOW
“Lateral epicondylalgia (LE), more commonly known as tennis elbow, is the most common chronic musculoskeletal pain condition affecting the elbow…” Read more
DRY NEEDLING
“Dry needling is a modern adaptation of traditional acupuncture using current biomedical understanding and research evidence.” Read more
As health practitioners, we must document everything we do in our sessions. We are meant to write up our notes during the time we are with the client, but no time ever feels like enough time to do everything you want with someone which means that the notes are usually done at the end of the shift or after the kids have gone to bed.
2025 resolution - do notes before going home.
Workers Compensation and CTP insurance also require feedback to GPs and Case Managers as well as reports and applications for more treatment which can take up some time... again these are meant to be done during someone’s session.
We re-book for next week so we can check her progress and tailor the treatment plan accordingly. It still amazes (and occasionally frustrates me) that the same injury on one person can be so different from another person’s and respond to treatments in such different ways.
COMPULSORY THIRD PARTY (CTP) INSURANCE
“If you were injured in a motor crash, you can claim medical and vocational rehabilitation expenses.” Read more
Mid-Morning Session: Building Balance and Endurance in the Gym
I look at my coffee mug but I'm already cutting it fine so instead stroll down to the waiting room (I usually get around 4k steps just from being at work for 5 hours which is an incidental win!).
My next client is on NDIS funding for Physio for a Neurological condition - we work together in the gym doing exercises to help him achieve his goals of improving his balance and walking endurance. We've been working together quite some time, and it is a real delight to see how his balance has improved.
There is a GLA:D class ↗ running at the same time in the gym (GLAD is an exercise-based class for those with knee or hip osteoarthritis) so the gym is busy, but the vibe is always fun. I enjoy watching those who are a bit nervous or hesitant on their first session knowing that in 6 weeks’ time they'll be powering through their exercises and then comparing dog photos on their phones with the veterans of the group (you know who you are!).
National Disability Insurance Scheme
“…maintenance NDIS supports… could include long-term therapy or support to improve your abilities over time or stop things from getting worse.” Read more
Patients in a GLA:D class ↗ .
mid-morning Challenges: From Tiptoes to Triumphs
We turn as a squeal pierces the air - it’s the younger sibling of one of our Physio's Paediatric ↗ clients who has just found the toy shelf whilst his older brother is being assessed for tip toe walking ↗.
Up and down the corridor they go. Now he's on to hopping - he's not keen but our Physio manages to convince him by turning it into a game - how do they maintain that endless energy!? (another reason the coffee beans must never run out!).
We finish up our session on the exercise bike and he half thanks me as he leaves - knowing he'll be cooked for the rest of the day but the long-term rewards will be worth it.
Notes, notes, notes.
Mid-morning Boost: Treats, Towels and Triumphs
My tummy rumbles - I should eat my apple from home but the snack cupboard, it is CHOCKAS after X-mas!!! (we have the best clients in the world who seem to know our tastes down to a tee). I grab a handful of Shapes before my colleague can finish them all and 3 chocolates (1 for now and 2 for the pockets) and chug down the rest of my now cold coffee.
I head back to the gym and nearly run into the Towel Man from Alsco Uniforms ↗ to replenish our dwindling stock. COVID has bumped up laundry prices and they don't seem to be coming down - so BRING YOUR TOWELS people - unless you want to see appointment prices increase!
Another post-operative lower back surgery client who has just finished doing our Hydrotherapy classes ↗, so I plan to progress her through to some work on the Pilates Reformer. Our Exercise Physiologists ↗ and one of her clients are also in the gym. He is doing an athlete screening on our new VALD force frame ↗. He performs the test and then they both ponder over the instant feedback on the iPad, high fiving and smiling when they see how much he has improved his quad strength since his last assessment ↗.
A Brief Pause: Emails and the Art of Staying on Track
My next client has just rung to say they are running 10mins late... I wonder if I will now be chasing my tail for the rest of the day... highly likely but it’s hard when you want to make sure everyone gets a good service. No worries, I'll fire off some reply emails to case managers wanting an update on a clients' progress.
Mid-Morning Battles: Managing Fear Cycles
Next client is an EPC client. GP's can refer clients on Enhanced Primary Care (EPC) plans where they can have up to 5 sessions of Physiotherapy ↗ (or Podiatry, Dietician, Chiro etc) over 1 year.
I read through the GPs referral letter:
Ok 2 sessions approved... medication list... X-ray report… moderative facet joint arthropathy… so I'm guessing they are coming for their back.
Turns out there’s a 20-year history of backpain that needs fixing in 2 sessions - I know my chances aren't great. The client is desperate for some relief today so while massaging their back, I flood them in back pain facts hoping that I can at least help them in knowing that their pain isn't being caused by some fragile/unstable structure in their spine and that knowing this may help dampen their fear cycle and encourage them into some movement that may bring their pain levels down… sigh... fingers crossed on that one.
Notes, notes, notes.
Enhanced Primary Care (EPC) Plan
General Practice (GP) Doctors can refer clients on Enhanced Primary Care (EPC) plans where they receive up to 5 sessions of Physiotherapy (or other Allied Health services) over 1 year.
Pre-Lunch Insight: Case Conferences and Tough Diagnoses
Case Conference time with a junior staff member where we discuss clients who have tricky or interesting injuries.
We look up a clients Imaging results on our web portal to see if they've had their MRI yet. Oooh nooo, a confirmed ACL tear and as the referring heath professional for the imaging, it’s our job to let them know about their season-ending injury... never a fun chat - but also a sense of accomplishment at picking up a "not to be missed" injury.
It's a weird job!
Lunchtime Laughs: A Pause for Notes and Team Updates
Half an hour for lunch - I eat it at my computer whilst finishing off notes, chatting holiday plans with colleagues, and trying to ignore the lolly container.
2 parcels arrive - one of them is a stock item ↗ (a knee brace for a client of mine) and the other is one of the girl’s online shopping - it was ordered over 4 weeks ago! lol...
Phone pings from the work group chat:
Work Mum: “First Aid Course renewal in 2 weeks and Online Ankle seminar ↗ on the 23rd 7pm if anyone is keen?”
A handful of 👍 likes
"Will there be free food?"
😂 laughy cry face emoji.
Afternoon session: Acro Rehab and Time Pressure
Last up a new client - a self-referred Private client who does acro (acrobatics). She has right hip pain and needs to get back to doing a double backward layout? I admit I have no idea what that manoeuvre is. She tries to explain to me what it is but, seeing as she can't currently demo it, we eventually end up googling it.
I try and mentally break down the range of movement and strength requirements to perform this crazy task and what her rehab is potentially going entail to get her back to this. We make a plan together, get started with her treatment and then she heads off.
I look at my watch - eek time to go pick up the kids. Those notes will have to wait... great start on that resolution...
Closing Thoughts
I love the variability of being a Physio. Every day is different, you see people in some of their most vulnerable moments and it is a real privilege to be trusted in guiding people through some of their best and worst times. Tears, laughter, highs and lows - and not just from the clients.
Not every day is rosy. I’m often asked: "does it annoy you when people don't do their exercises?"
No, it annoys me when the Government cuts funding to the NDIS and a vulnerable client falls because they can’t get the Physio they need anymore and dislocates their knee and ends up having to have more surgery.
It annoys me when a client who has been in a not-at-fault car accident and is still barely walking has their CTP salary payments cut off prematurely and is forced back into heavy labouring job despite not being ready at all.
I could go on, but I won't. These are systemic issues that won’t be changed with a blog. We have to learn to detach from emotional luggage in some way in order to not become "one of the numbers" of Physios that retire to due burn out.
But if I could go back to Uni and start all over again, there's nothing I would change. It's an amazing and rewarding career and I've been blessed to work in some amazing clinics.
So if you have ever thought about what it's like to be a Physio, want to become a Physio, or wonder why we always chewing as we walk out of the staffroom, I hope it has given you some insight into a day at Shellharbour Physio.
Just found those last 2 chocolates in my pockets by the way... melted... still good though...
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