What is the difference between physiotherapy, osteopathy and chiropractic? Why did I become an osteopath?
“What is the difference between a physio, osteo and chiro?” This is probably the most common question that osteopaths get asked. It usually is preceded with, “This is probably a stupid question but…” So, it certainly is not a stupid question, it is very common and I’m certain there will be different opinions from different practitioners in the different professions.
I’m going to do my absolute best to limit my bias for osteopathy when comparing it to physiotherapy and chiropractic. For me to do this I’m going to briefly explain why I chose osteopathy over the other two professions. It all goes back to about grade 9 in English class, where we had to write an essay on what career we wanted to pursue after school. Now I have always loved sport and movement, that was all I really had a passion for. I had no idea at all what I wanted to do with a career, but knew it needed to involve sport or health. I asked my friend Jordan what he wanted to pursue, with him replying he wanted to be a physiotherapist. It was a bit of a light bulb moment for me really, I was sold on physio thanks to Jordan.
Then the next few years I took football preseason as seriously as I could. Being Australian Rules Football, and the position I played, I needed to be a very good runner. I was running multiple times per day completing high kilometres at a high intensity. If only I knew what I know now about appropriate loading and how to manage my training loads. Of course, injury occurred which was primarily pain and loss of power in my groins and hips. The injury got significantly worse over the years. It took me two years to admit I was struggling and needed help, very silly! So, I went to see a physiotherapist for the first time, to help me overcome this injury that seriously affected my physical/mental health.
This physiotherapist had me in weekly, doing ultrasound to my groins, massage and provided theraband exercises for my groins. I’m not sure how many appointments I went to, but they were all the same. The exercises were the same, there were no progressions or exercises for other regions. Even the treatment each time was the same. I ended up getting nowhere with this physiotherapist and basically went back to football underloaded and still with pain and functional limitations on performance. The physio gave me no education, no relief, no hope if I’m honest. With it being my first experience with a physio and the career I wanted to pursue, I was made up that physiotherapy sucks! I had not even heard of osteopathy before and I’m not even sure who made me aware of the profession. But my physio experience left me sour and the osteopathy holistic view just made a lot more sense. I enrolled into osteopathy at Victoria University, with my first osteopathy appointment being in my second year of study (believe it or not!) Did I notice a compelling difference between the two professions from these two appointments? Absolutely I did, although I was getting treated for shoulder pain not chronic groin pain. So, there it was, I hated physiotherapy and was delighted osteopathy was the career I chose.
Another common question I get asked which is always humorous is, “You guys all hate each other don’t you?” Now at that time, I probably did hate physiotherapy. However, it was probably after graduating and working as an osteopath that I realised we all think and treat so differently. I realised that there are also very bad osteopaths out there. The physio who treated me for my chronic groin issues was just a bad physiotherapist. Physiotherapy itself can be great, just like osteopathy and chiropractic. It really comes down to the person you see and how they approach your management. If they provide high-value care and are genuinely a decent human being with your best interests at heart, you will likely have a positive therapeutic outcome.
How do you know they are providing you high value care?
This practitioner will have all these qualities (like we do at The Reform Lab Osteopathy!)
Listens
Provides reassurance and improves confidence to function by reducing fear
Validates your pain/injury and story
Provides evidenced-based education on your pain/injury
Promotes physical activity
Tailors treatment to your personal goals and expectations
Includes you in the treatment decision making process
Uses active approaches (exercise therapy to promote self-management) alongside hands on therapy
Does not rush your appointment so they can get more patients in the door for $$$
Does not try get you in every week for the next 6 plus weeks (they probably just care about your money if they do if I am honest)
Encourages questions throughout the appointment
Get to the differences Jackson!
Well, if your practitioner provides high value care then there will be a significant overlap between the three. They all have completed a minimum of 4 years university training and are primary healthcare practitioners (meaning you do not need a referral to see one). However, here are the key differences between the three professions.
Physiotherapy
Focus on being evidence-based; their treatment should (if they are good physios) align with the best research.
Exercise therapy and rehabilitation focused – Considered experts in this area.
Their manual therapy training is often limited and they complete further courses to maximise their hands on skills – Spinal manipulation techniques for example.
Historically have been very region specific in their treatment approach – The good physios have advanced past this and are more holistic in their treatment (which is the way osteopaths treat.)
Chiropractic
Experts in spinal and joint manipulation techniques.
Underlying philosophy that if the spine is misaligned then disease will occur – This has been proven incorrect many times with modern science.
Exercise and rehabilitation training is limited and they will undergo further training – The good chiropractors will promote exercise and use hands on work as an adjunct.
Osteopathy
Treat and think holistically due to the osteopathic philosophy: “The body is a unit and the systems operate together.” They will look and treat more than the site of pain/injury.
Very hands on traditionally, and highly trained in manual therapy techniques.
Exercise therapy and rehabilitation training is not heavily focused at university (this needs to change) and as such have to complete further education (the good ones do and implement it in clinic). I personally have learnt from the best physiotherapists in the world for further training.
Seen as alternative in the traditional medicine sense and not considered evidence-based (the good ones are).
So, there are the differences, with the overlapping similarities to treatment and management. They are trained to diagnose, treat with manual therapy and manage with exercise rehabilitation. If they are sticking to the checklist of a high value care practitioner, and you personally get along with them then you are most likely going to have a positive experience due to a strong therapeutic alliance.
I have said this a few times in my posts on Instagram, I am a practitioner who thinks (holistically) and treats like an osteopath. However, I manage like a physiotherapist with exercise rehabilitation as the fundamental component. I stick to the values of what makes a high value practitioner and ensure that you are getting the most modern evidence-based treatment.
I’ll conclude by saying that no profession is better than the other in my opinion, in fact I believe in future we will all be called the same thing. Whatever that may be, positive change is coming through healthcare with the overlap between the three professions. Oh, that friend Jordan also become an osteopath a few years after I graduated.
