Onsite Physiotherapy – What can it do for you?

Author: Adrian Ong

As a physiotherapist, my main objective is to help my patients and clients recover as much function as clinically possible to help them achieve their goals. It was my experience in private practice that helped develop my clinical interest in chronic complex pain. I found out that 1 in 5 Australians aged over 45 was crippled by this illness, and according to the Australian Bureau of Statistics report in 2017-2018, the top three conditions affecting most Australians that lead to chronic pain are mental and behavioural conditions – 20.1%, back problems – 16.4% and arthritis – 15.0%.

Workers Compensations – Australia
I’ve observed that a great number of my patients experiencing pain of >3-6 months are mostly represented by people who have work-related injuries and on serious compensation claims, and I am certain that it is not surprising to most of you. According to the 2020-2021 statistics from SafeWork Australia, 130,195 Australian workers’ claims were considered as serious claims, and on average, these workers completely lost the capacity to perform their role for 7 weeks. This number has been on a steady increase for the past few years as shown in SafeWork Australia’s statistics with 120, 355 cases in 2019-2020 and 114, 435 in 2018-2019.

On top of this, more than 50% of these cases are due to body stress, falls, trips, slips and being hit by moving objects, which all result in musculoskeletal conditions. And what’s one of the things we, as physiotherapists, are good at? DIAGNOSING AND TREATING MUSCULOSKELETAL INJURIES! So, after seeing the numbers, it started a domino of questions, “Why is this the case?”, “Is there a better way that I can help this patient cohort?”, “How can I be part of the prevention rather than just the treatment?” With the guidance of a great mentor, I was introduced to the field of occupational health physiotherapy, which I didn’t really hear much about when I was still studying, and I believe that this is a great solution to the problems I am facing.

Occupational Health Physiotherapy
Occupational health physiotherapists focus on prevention and treatment of work-related injuries as well as providing a suite of services aimed at identifying risks and hazards early to reduce incidence of injuries. I had the opportunity to speak to one of Axis’ directors and shadow one of their team leaders, and this is where I learned that there is a subgroup of occupational health physiotherapists called onsite physiotherapists, who work within a company, factory, or warehouse to provide care to all employees of a particular business. Now that I’m working as an onsite physiotherapist, I believe we have better access to two very important things that other physiotherapists do not, and these are the injured worker’s workstation and the key stakeholders of the business. These key components grant us access to first-hand information, which in turn, provides us the ability to best support the injured worker and the business. So, how can we assist in the prevention of chronic pain? Amongst our duties include providing early intervention care and reducing incidence of injuries.

Early Intervention Physiotherapy
Early intervention, to me, means seeing an injured worker within 7 days of the injury, preferably within the first 3 days. Since majority of injuries occurring in a workplace result in musculoskeletal injuries, I believe that onsite physiotherapists play a crucial role in being a primary healthcare contact when an injury occurs. We have a good grasp of musculoskeletal conditions, which allows us to properly diagnose, treat and de-catastrophise the injury. I added de-catastrophise because upon looking back at my patients’ records, I noticed a trend of these workers getting sent for scans immediately, even if it could have been avoided.

Pre-emptive Injury Reduction
As an onsite physiotherapist, my role does not stop at treating patients. Most, if not all the sites I go to, permit me to visit different work areas and speak to all employees, which gives me insight to their concerns and learn what tasks and areas they believe exposes them to higher risk of injuries. From there, I am certain I can play a part in preventing chronic pain by helping prevent an injury from happening by performing job task analyses and risk assessments.

You’ve probably heard of the famous saying, “An ounce of prevention is worth a pound of cure.”, and this holds especially true in helping reduce future cases of chronic complex pain. However, if we want our prevention measure to stick, we must ensure that it is sustainable. From my point of view, having an onsite physiotherapist is a cost-effective and sustainable means of thwarting chronic pain from crippling our workforce.