To be thoroughly pissed off that I’ve only been offered a video call for physio therapy?

[WhatAWonderfulLife]

(I’ve posted about this before I’m in pain and grumpy this afternoon and need a rant)

about four months ago I was completing couch to 5k and during a run felt my knee “pop”, it was seriously painful but for various reasons I couldn’t seek medical attention then. I self referred to physio then, but had to cancel due to recovering from surgery.

since then my knee has got worse and worse, it feels very loose inside and when I walk it feels like it’s very weak. I was referred for physio again and the appointment is in four weeks, for a video call!! I just feel so fed up, it’s to the point now where if I go for a walk it’s painful up my thigh and down my leg. I fell over a week ago and I think I’ve jarred it even more. I just feel so fed up and can’t see that a video call will do anything to help as surely they can’t actually diagnose anything that way???

Might be worth giving it a try before dismissing it. I had a BUPA online physio appointment. Helpful diagnosis, exercises provided, injury improved dramatically.

DF had a bad back and a physio appointment by 'phone. After two tears of no improvement he saw someone privately, had a scan and it's a rare, extremely serious problem that could have left him paraplegic.

...years...

I'm a NHS physio. We can often work out what the injury is from what you tell us. They may well book you in for a face to face appointment afterwards.

With regard to imaging, it is often only done if there is a surgical target. Some meniscal tears can be dealt with by physio, depending on the type of tear that it is (assuming that is what you have).

I understand your frustration but please don't think it's a waste of time. Unfortunately, the same as the rest of the NHS, we are working with limited resources.

In most areas you have to see a physio before being referred to consultant/for more tests etc. As most NHS physios are now hands-off, they can pretty much do the same job on video link, especially for the first appointment, where it's gathering your history and agreeing the next course. If you insisted on a face to face appointment you'd probably be waiting a lot longer.

Sadly, most of the time we have to accept the NHS offers or pay for more, often what's offered isn't the No. 1 choice of the practitioners but is the best their budget allows.

I appreciate this isn't what you were expecting or necessarily need, but for many, it may enable an onward referral more quickly/efficiently or an appointment with the right person. It should allow the physios to see more people than solely face-to-face.

It's not just physio therapy OP. My cardio "rehab" consisted of 3 5minute phone calls over a 6 week period. Every question I asked was answered with "oh that information is available on the BHF website". Total waste of time.

But are video appointments any faster? Do they save time? I don't think they do. You still have to ask the same questions and get the patient to do the same movements so why not see them face to face? I agree the history is really important but I don't get why people think video/ telephone appointments mean you can see more people. I was an NHS GP and honestly seeing people face to face was much easier than on the telephone. Our practice abandoned most telephone appointments in late 2021 as we were all too stressed with having to spend 10 minutes on a telephone call then have to see the patient anyway. Maybe I'm a bit of an old fashioned medic but nothing replaces face to face...I know NHS managers control a lot of what you do but let's not forget our training

I agree, I'm not saying they're as good as a face to face. I much prefer seeing the patients in person. The only time we do video appointments where I am are if either the patient is unable to make it in e.g. transport issues, or if a physio is not able to be in the clinic that day e.g. have a cold but still able and willing to work, without risk of spreading it. However, if it's the choice between a video appointment or many more weeks of waiting (19 weeks in my area for routine appointments), I just wanted to reassure OP that it won't be a complete waste of time.

But surely it costs the same (if not more) to run a virtual clinic than a face to face

My husband had a phone appointment. It didn’t help at all. Eventually he got a face to face and that did help. YANBU.

unfortunately you need to massively readjust your expectations as NHS physio isn’t worth the time of effort of travelling to an appointment. If you want any physio that works you need a private physio. You also don’t need surgery for a meniscal tear. They can operate but can also leave them. I had a tear identified at the same time as a much more serious knee issue was identified and my 2 tears were left and has caused me no issues (after a period of rest and physio)

They're extremely reluctant to do imaging whether you see them face to face or not. As others have said, it's best to massively lower your expectations.

It's purely information gathering prior to an appointment. To be fair you have been offered opportunities to be treated which you didn't take up and delayed it being seen when the injury occurred so it's not exactly their fault.

YANBU.

I have also done a physio self referral for my knees(and lower back).

I did see the GP first, because I thought it may be arthritis. GP said the one knee was definitely swollen, gave me a referral form to book x rays for both knees and said to do a self referral to physio. X rays confirmed the cartilage is worn.

When doing the online referral there was an option to select telephone, video or face to face. I can't quite get my head around how they would make a proper assessment other than face to face, so chose that option.

I have had physio previously for my achillies, and a rotator cuff injury, which resulted in a frozen shoulder. On both, they felt not only the area of injury, but the surrounding area. With the shoulder, I was asked to push against her hand, and other things, so she could feel the resistance etc on more than one appointment.

Was worth me travelling to an nhs physio. I had a series of appointments, about 4 to 6 weeks apart. The exercises I was given to do was changed slightly at each appointment, based on the progress I had made. Went from having limited movement and pain in my shoulder, to increased movement and less pain as time progressed. After about 5 appointments was signed off - had full movement back abd very little pain.

Hoping they can help with my knees later this month- had physio for my knees in my teens but that was a long time ago, and the same exercises may not be appropriate now.

Dh had a meniscus tear, our friend works in a private hospital and examined his knee and told him he would need surgery.

Dh went to the GP, first it was steroid injections into the knee, finally a scan that showed he had torn his meniscus and finally surgery. Luckily the wait time was longer than their targets so he had surgery at a private hospital. From him tearing it to the actual operation was over a year. A year of agony, of limping, stupid waste of time steroid injections. That was 10 years ago.

He recently went to a NHS physio appointment for a back issue. He got an appointment 3 days after seeing the GP. She didn't even touch him, just showed him images on Google to diagnose him and then emailed him some exercises to do when he couldn't even really walk. He couldn't do the exercises. Fortunately we could pay for private physio which massively helped.

I feel your frustration OP - after suffering with a very painful hip (my chiropractor had told me it was probably arthritis) I went to my GP who referred me to physio. (This was done quickly and I was really happy with that). However, when Iwent to see the Physio he was quite dismissive, asked him if I could have a scan, he said no, gave me 6 exercises to do and told me to come back in a couple of months if the pain had not gone Said it was basically "wear and tear". It then took him a week to email me the exercises, I had to phone 3 times to ask for them. . Didn't even show me any of the exercises in ou allowed time, no hands on, just do some exercise come back if you are still in pain. I eventually paid for my own x-ray to find out I have severe arthritis in both my hips, areas bone on bone.

NHS has massively scaled back on actual physiotherapy . I had to wait a month for 2 (!) minute face-to face appointment

she just asked me to stand on one leg, said if I had something broken I would not have been able to do that , and she’d email me some exercises.

the end

(had to sort my own rehab via YouTube tutorials)

My Dad who is in in his late 70s and recovering from a shoulder replacement has just been offered his phyio appointments over the phone.

Private physio is not hard to come by, there's multiple clinics just near me. Any reason you can't just book an appointment directly with a physiotherapist? Rather than going through referral or private health care?

Because I can’t afford to go private.

I’m going to see what the physio says over the video call, but I’m pretty convinced it’s a meniscus tear at this point. It looks like the cost of treating it privately could be close to £10k! Which I don’t have

The physio clinic near me is free consultation then £60-£70 per appointment. I'd use a credit card if it was going to help a lifetime of pain and potential disability.

Obviously it depends on your specific diagnosis and if you need surgery, which they can't help with. But if it's physio you need asap then there are clinics for that

Not everyone has £60-£70 spare