With nearly 35 years of experience as a physiotherapist, Elizabeth Sutton has grown in her understanding of pain, patient care and being investigative as a therapist.
Her career began mostly in the neuro/senior setting, and then over time she transitioned to orthopaedics. What was supposed to be a short move to Lethbridge in 1988, became long-term after she fell in love with the region and the man who became her husband.
In 1992, Elizabeth and a friend opened their clinic, Peak Physical Therapy, and has been sole owner now since 2004. They focus on musculo-skeletal injuries, but also take a few neuro and respiratory patients.
“The best part about being a physiotherapist is putting together the pieces of the puzzle that makes up a patient’s pain. Helping them relieve their pain is great, but helping them figure out how to prevent it from coming back and returning to the activities they love to do is the best!”
When she isn’t helping a patient, you will find Elizabeth enjoying hiking, reading, spending time with her family and travelling.
With her years of expertise, here are a few great tips to keep in your back pocket as you develop your own physiotherapist career.
What you learn in school is only the tip of the iceberg – there’s so much more out there to know! On the flip side – taking too many courses too quickly doesn’t give time for the information to “gel”.
When I graduated, I started taking ortho level courses (back in the day when they were called E and V’s.). I can remember feeling somewhat overwhelmed and had some difficulty applying what I learned in those levels. Then, I moved from Manitoba to Alberta in the late 80’s before easily accessed records, so I retook my second levels. They made so much more sense when I had more patient visits in my experience.
I found the same thing with my McKenzie courses – I took the A and B levels in the 90’s but didn’t get to the C and D till the 2000’s. Material just “clicked” when I could think of several examples in my head of those I had helped and those I hadn’t. It didn’t necessarily make studying for my certification exam any easier though!
Patients didn’t “read the book” but still got better doing something I thought wouldn’t help. For example, I had many patients I advised to use ice and hated it but would feel better with heat!
I’ve had many patients over the years that I thought should try ice, but invariably would come across patients who would do better with heat. I’ve since come to understand pain a bit better and that it may not matter what they try as long as it isn’t dangerous. If it allows them to do the exercises I know they need to do to help the area heal, restore function and prevent recurrence, I’m all for it now!
If you don’t take the time to help your patient understand why you want them to do a particular exercise – they won’t do it.
This is especially true for people who do not exercise or do not do regular physical activity – the so-called “couch potato”. It can be difficult to engage them in their program if they are not functionally limited by their pain. And try to convince someone who doesn’t like exercise to do a squat! Even those who are relatively active can be hard to convince. Many people in physical jobs or those with active hobbies (like gardening) often feel they “do enough” activity. They often just want something to calm the pain down.
My goal is not only pain relief, but return to function AND prevention. When I started to talk to people about how their activity uses some muscle groups a lot and others not as much, thus creating an imbalance, they would start to get it and follow through with their homework. For the couch potato, it can still be a challenge, but I try to take a “less is more” approach – if one or two movements will help, I stick to that till they develop the habit of movement before adding new ones.
Pain is deceptive – someone can have minimal or no damage but tons of pain. Someone can have minimal to no pain but tons of damage.
I use the example of a paper cut: a small area of “not much damage” can cause a crazy amount of pain especially in the thumb. Conversely, I have a friend who was rendered quadriplegic in a diving accident years ago. Major damage – didn’t have any pain – said his neck felt “off”. That does not mean we shouldn’t pay attention to pain; we should view it with some suspicion as it doesn’t tell us what is wrong.
Just because an X-ray or MRI shows something, doesn’t mean that’s what’s wrong.
There are loads of studies out there with percentages of asymptomatic people with positive findings on so-called diagnostic tools. Lots of symptomatic people with negative findings on the painful side, and positive on the “good” side. I’ve been using these examples to explain to patients why I might not need to see the tests as I am treating them not a picture.
If the patient didn’t do anything to strain their hamstring, it is not a hamstring strain.
If a patient can’t remember hurting a specific body part – it’s most likely a spinal related issue. My usual example is the hamstring strain. I’ve had several patients over the years who were told by their MD that they have a hamstring strain, but they hadn’t lifted any weights or anything out of the ordinary, and couldn’t remember doing anything to that area. They’ve tried stretches, massage and loads of other things without the pain going away. Do a back exam and change their routine – and the problem goes away.
Doctor’s spend 90% of their training learning about things that could kill you, but only about 10% on the MSK system, so if they say someone has a strained/sprained anything – take it with a grain of salt.