What is the difference between neurological physiotherapy and orthopedic physiotherapy?

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Did you know that there are many different areas of expertise that a physiotherapist can practice in? One of the most common questions we get asked is what is the difference between a neurological and orthopedic physiotherapist.

Neurological Physiotherapists

A neurological physiotherapist treats people who have sustained an injury to or have a disease or condition affecting the brain or central nervous system - such as:

  • Traumatic or acquired brain/head injury

  • Stroke

  • Balance disorders

  • Spinal cord injury

  • Other neurological conditions/diseases (i.e. Parkinson's Disease, Multiple Sclerosis, Cerebral Palsy)

These neurological conditions are complex and affect the whole person - physically, emotionally, and cognitively.

In addition to the standard registered physiotherapy qualification, a neurological physiotherapist has specific knowledge, training and experience in:

Normal muscle tone and fascial tissue allows a person to move freely and automatically without effort or thought. Following a neurological injury such as a brain injury or stroke, tone may be increased or decreased, making initiation of movement effortful or impossible. The neurological condition/injury may also cause abnormal alignments and compensatory movement patterns that can cause pain, and interfere with balance and mobility.

Our neurological physiotherapists are trained to see and feel these problems and provide hands-on treatment rather than modality-based interventions. This hands-on treatment facilitates input to the brain and central nervous system to modulate tone, release tight fascia and re-establish more normal patterns of movement. This can be viewed as the therapist's hands "talking to the brain" to change what is abnormal to more normal and automatic functioning (i.e. seeking to enhance neuroplasticity).

As with all interventions with serious or catastrophic injuries, neurological physiotherapy requires long-term intervention and supports an inter-disciplinary approach to rehabilitation.

Orthopedic/Manual Physiotherapists 

An orthopedic/manual physiotherapist treats people issues within the musculoskeletal system, assessing and treating injuries and conditions that affect muscles, tendons, nerves, ligaments, fascia and the skeletal system. These therapists treat injuries or trauma like strains, sprains, stiffness, post fracture or surgery, pain, restricted movement and postural alignment issues. Orthopedic/manual physiotherapy can help treat:

  • Chronic pain

  • Injuries

  • Falls

  • Arthritis

  • Muscle, bone, joint pain

  • Sports injuries

  • Sprains and strains

  • Neck, back, shoulder pain

  • Motor vehicle accident injuries

  • Whiplash

These therapists also use a whole-body approach in their assessment treatment process. Rather than just looking at the area of pain or restriction, our therapists expand their assessment to looking at the whole body and where the root cause of the problem may be. In addition to the standard registered physiotherapy qualification, a orthopedic physiotherapist has specific knowledge, training and experience in:

Our orthopedic/manual physiotherapists may use some equipment and modalities (i.e. an ultrasound) during treatment but the majority of the treatment is done using hands-on techniques. Treatment is done one-to-one in private treatment rooms, meaning the therapist treats only you for the duration of treatment session.

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