Mark: Hi, it's Mark from TLR. I'm here with Wil Seto of Insync Sports Physiotherapy in Vancouver. And we're going to talk about what is the difference between a sports physiotherapist and a regular physiotherapist? How are you doing Wil? 

Wil: I'm doing great Mark, thanks. Yeah so a sport physiotherapist is essentially someone who's completed what's called their diploma in sport physiotherapy through the division of Sport Physiotherapy Canada, which is part of our Canadian Physiotherapy Association. And so someone that has completed this extensive training they have the experience and the skillset to take care of athletes at all levels. So whether it's like high performance sports, like when you're working at a national or international level to national level provincial level or everyday activities. 

Mark: So, you know, just to maybe flesh that out a little bit, like you've worked at the Olympics, you've worked with specific national teams, whether they were in Canada or other countries in a range of different sports. So maybe just outline that quickly for us. 

Wil: Yeah. So as a sport physiotherapist we're qualified to work with Canada's high performance athletes in all settings, like I was saying. And so we have that skill set and training to be able to work with athletes and teams in daily training competitions, like you mentioned in world competitions and Olympic games. And part of what's helped give us that ability to do that is that there's this very stringent, I guess we call it an examination process where you know, you have to pass in order to actually achieve the credentials and the designation as a sports physiotherapist.

And essentially the Canadian Physiotherapy Association, they oversee this program, which is called the Clinical Specialist in Sports. And this program essentially allows the diploma in sport physiotherapy to be the designation of advanced clinical reasoning through sort of what's called like a peer review or competency-based program. And this is a national recognition program. And in fact, these are international standards as well. 

Mark: So if we could boil it down, like a physiotherapist goes through a tremendous amount of training to know the physiology, anatomy, all the rest of it, how everything interplays, how does that transfer then into being a sports physiotherapist? Like what's the difference? 

Wil: Yeah, that's a great question. So essentially the sport physiotherapist, has that experience, like I was saying, that skill set to work with people to return to sport or work or even things like life-related things and those aspects of a treatment plan.

So we can come up with a carefully planned progressive exercise program that will basically allow you to do those things and get you back to doing activities in a safe manner and reducing the risk of reinjury. And so there is definitely obviously like with that credential program where you have to have a thorough understanding of also a lot of other areas. So just with sports, there's other things to consider like concussion and treatment protocols for that too. And so with our background, we also have an extensive background in orthopedic knowledge and then the added skills that we've obtained and learning how to work with people on a clinical setting as well. That's very helpful. 

And the skill set of athletic taping. So then we are actually become very advanced in learning how to do those things to help athletes or even  non athletes, you know, like you sprained your ankle, but you're really active and you want to get back to just walking around, hiking, short little hikes or something like that to get you back moving again quicker, more safely and have a more comfortable experience doing that as well.

Mark: So at your clinic, you're sort of the leader of a fairly small Canada wide cohort of people who have the Sports Physiotherapy Diploma. What was the numbers again? There's what, 10,000 physiotherapists in 250, am I right somewhere in there, are sports physios? 

Wil: Yeah. So there's just over I think like 250, or I guess more recently, maybe 300 physiotherapists who are now sports physiotherapists in Canada. So there's a two-step process. There's sort of like your certificate level and then your diploma level, which is then you can say you're a sport physiotherapist. And then at the certificate level, there's something like, I think maybe just over 350 or 400 all across Canada.

Mark: So tremendous amount of training to get there, but then to simplify it, and no disrespect to regular physiotherapists in any way shape or form, but you guys become sort of the super physiotherapists. Can I make that distinction? You've gone to a whole other level of training that's specific to sports injury and sports rehab that a normal physiotherapist does not have.

Wil: Yeah, there's definitely some physios out there that you know, they may not have gone through the system that are excellent physios. And fortunately in our group, we have physios that are also going through that process, that our certificate holders and that are about to complete the diploma to become sport physios.

And I think the biggest  thing is that because this is not only a nationally recognized program, there's also international recognition. So when you become a sport visit therapist, you know, there's this international recognition of the credentialing of this program that is applicable across a lot of standardized countries where you can say that as a sport physiotherapist in Canada, you know, these are the standards that we hold. 

 I think a large part of this is that there's a huge skill set in what we do working with this clientele. You know, and obviously there's other skillsets that other physios that don't do this, like for example, I talked about concussion management and emergency protocols. And essentially what we are, as sports physiotherapists, is that our skill sets also include like I was saying, stuff like athletic taping, more specific stuff of functional return to sport training and functional activities. We're experts in the areas of getting athletes back to these areas because of also our exercise physiology training and stuff like sports massage and  concussion evaluation and management.

So, you know, really as a sport physiotherapist we have the skills and ability to work with larger organizations and to help with teams and athletes establish these comprehensive medical support systems for them whether or not it's like grass roots or high-level performance. And so as a sport physiotherapist with a diploma, you work with Canada's top athletes at all levels of sport. 

And what we do essentially, we've worked at all these different games and get all these experiences and now we bring it into the clinic and we can develop a treatment plan and help work with you. And also develop the clinical skills that we've received and gained from on the field, like at the moment of injury and all those things and take that and help our clients when they actually walk into the clinic on a clinical setting. So to me, something that's been very invaluable and that's really benefited a lot of my clients and a lot of the clients that I've seen that other sports physiotherapists I've worked with in the past.

Mark: So one of the things you are actually and not irregularly, somewhat regularly, you're right there at the field. Say it's soccer, you're there at the soccer field and they're training. And perhaps there's something that you're noticing that you might say, you know, what, if you added this component into the training system, you're going to have less knee injuries, for instance, because a lot of cutting. Say basketball. Could be hockey. Could be you name the sport. You're going to have that knowledge to say here's how to develop that whole tendon muscle strength system so that joint is protected and you're going to have less injuries. That's kind of the level of detail that you guys are trained to. Is that a fair assessment? 

Wil: Yeah. That's a really good question and some points that you bring up and I think as a physiotherapist, the best way to describe what we do to someone that's never really had physio is that we're movement specialists. So we help people move again. And as a sport physiotherapist, you take that to a whole new level.

And so now with the sports that I've worked with, you know as a sport physiotherapist, you're also required to, it's a requirement actually that you have a few sports that you work with specifically, so that way you can work with a team and manage the team. So, you know, that kind of complexity of that team management and you work with individuals sort of on a longitudinal scale. So you work with them throughout seasons. And then you also work with a breadth of different sports and different movements and activities that way you kind of have a broader scope of movement and stuff like that. 

So and that's really important because then as you start to look at how different sports can crossover, you'd be like, oh yeah, you know, I've worked with rugby, hockey, soccer, field hockey and all those fields sports, and they are really relatable in a lot of ways. But then there's also very, very small individual specific things to those sports and positions for players in each area. So someone who plays rugby that plays maybe in a scrum, you know, a lot of different rehab components to consider and movement dysfunctions to help them rehab through versus someone who plays ice hockey as a centre or even a goalie. 

So there's all these things you've got to consider. So I think that's huge. And so to answer your question, yeah, definitely, it gets into a little bit more specific in terms of us being movement specialists and having that bio-mechanical knowledge and applying that and being able to now use specific evidence-based practice exercises and things that we can do to help you get back in the game faster, more safe, and have a more enjoyable experience. 

Mark: So if you need some help with your sports injuries or non sports injuries, you can book an appointment at Insync Physio. They have two offices in Vancouver and in North Burnaby. Go to the website insyncphysio.com. You can book for either location or you can give them a call in Vancouver 604-566-9716. In North Burnaby 604-298-4878. Thanks Wil. 

Wil: Thank you Mark.

There’s a lot of stuff I really love about being a physio, it’s hard to wrap it up into one nice statement. I think the thing that gets me the most excited is that physio is a helping profession that has its roots in the foundational principles of exercise and education.

What I love is I get to help people to help themselves - which I think is really cool. I get to help people utilize the capacities that they already have within their own bodies via exercise and movement, and I get to help them become more familiar and in tune with their bodies and their pain and help them to understand their injuries a little bit better.

And then from there, be able to give them the strategies and the resources that they need to be as independent and self-efficacious as they can in their recovery and rehab.

I think I have kind of the typical story of growing up, playing a lot of sports, and having a lot of injuries myself and being exposed to the profession in that way - so I’ve always been very drawn to it from a young age, I’ve always found it very interesting. I’ve also always been very passionate about the human body and its resiliency, it get’s me really excited. I’ve always loved anatomy and physiology, the sciences, biology, and I love sports; and I wanted to do something where I could help people. So I think a combination of all of those things wrapped up nicely as physiotherapy.

I chose to work at InSync for a variety of reasons; I wanted to find a clinic that gives me the time and the space for one on one time with clients. I think that everybody deserves to have really good one-on-one focused care with a therapist, and having the private treatment rooms and longer time frames to spend just one-on-one is really important to me. And then also I really wanted to work somewhere where I was encouraged to not be stagnant as a physio and encouraged to continue to grow, and InSync is really good for that - they have regular mentoring sessions where physios get together and they challenge one another and push one another to continue learning and to be better.

I am obviously very much a movement optimist, so I love to move myself - you can usually find me in the gym or running up and down the stairs to the beach in Kitsilano, or running the seawall. I also really love to play soccer. In the winter I love to ski - I spend a lot of time downhill, backcountry, cross-country skiing. If I’m not moving you can usually find me at the local beer scene or food scene with friends, or curled up with a good book or good research paper.

I think I’m a pretty open book - I really love treating a wide variety of people, from those with persistent pain, like chronic low back pain, to those with neurological conditions - I have experience working with Multiple Sclerosis and PD. I love working with athletes, people who have just had surgery, or have been in a motor vehicle accident. I have a really big interest in concussion and vestibular rehab so stay tuned for future Anna when she gets those credentials! 

What do you like most about being a Physiotherapist?
I like that I am able to do an assessment and pin point what might be causing someone's discomfort or pain and then from there, being able to decide with the client what solutions might be beneficial for them to make a long-lasting impact for their life.

Why did you become a Physiotherapist?
I became a physical therapist when I realized that most people, live with some sort of pain in their life. Whether that means they have some of neck pain from studying or pain from day to day activities, or just knee pain from running. I think that most people are aware of the traditional medical approach with dealing with pain but not everyone's aware of the benefits that physiotherapy has. I want to be a part of that change.

Why did you choose to work at INSYNC PHYSIO?
Well, first of all I really like that INSYNC wants to build this bond with the community and the commitment they have with their clients. One of the things that stood out to me was that INSYNC offers focused one on one treatments, which to me emphasizes that they really do care about their clients and they want them to get better. I also like that they are onsite and available at a lot of sports and community events. Aside from helping people who get injured during these events, they bring awareness to the community as to how physiotherapy can help.

What are your outside interests/ hobbies?
I love trying new things, I love eating, I love finding new places to eat, I love travelling… that’s kind of what I like to do.

What is your special interest / focus in treatment if any?
I really like treating necks and backs. The reason why is because I think that everyone at some point in their life will have some sort of neck and back pain. I think those are the two areas that piqued my interest and are things that I am passionate about.

The thing I like most about being a physiotherapist is just helping people walk through their goals and their rehab, their rehab stages, I really enjoy the fact that I get to talk to people on a daily basis.

I always knew from a young age when I was eighteen picking my profession that I didn't want to sit in front of a computer nine to five, just couldn't do it. I do have to use a computer still with this job but  I don't have to do it full time so that's great.  I also get to like, its like problem solving, I like to come in and be a bit of a detective and kind of figure out what's the root cause of somebody's problem.

I don't believe in like relying on analgesics for short term fixes so I believe in conservative management for many many different injuries is much more important, than just a quick fix in a doctors office.

And why did you become a physiotherapist?

I was involved in lots of sports from a young age. I played hurling which is an Irish sport.  One of the fastest field sports in the world actually.  Played rugby as well, played soccer, tennis every sport you could think of. Probably too much actually because I got injured on numerous occasions.  But the injury I remember the most is that dislocating and breaking my left elbow, my ulnar nerve which is the nerve that passes back here. Got impacted and I had a bit of tingling into my baby finger which I found out later on what that was all about. But I enjoyed going to the physiotherapist and I kind of thought to myself this would be a really nice way to actually make a living out of.

Biology was always my favourite subject in school. I went to the west of Ireland a place called Galway to do physiology. That's kind of what I majored in, that's kind of looking at the body at sort of a molecular level, ions in and out of cells. Kind of complex stuff but a little too micro. So I decided to do a masters in physiotherapy in Edinburgh in Scotland.  I brought it up to a macro level.  I enjoyed the whole anatomy and the fact that most of the language comes from latin which I kind of enjoy actually.

And why did you choose to work at Insync Physio?

I choose to work at Insync Physio because it's a small clinic which I quiet like, it's kind of personable, you can become much more friendly as opposed to being lost in a nationwide company. I worked in a nationwide company back in England and I felt like I was just a number. So here its a lot more personable there's Physios that get together. We get together once a month. We sort of bounce ideas off one another and we can sort of come up with the latest research, techniques, sort of investigate each others techniques. And that way we can become better practitioners actually. The other thing I like about here, is it's kind of patient centred it's one on one. You build a lot of rapport. It's not just like a factory setting where your getting clients, rush them through the door in and out, thanks for coming, it's more just like one on one, 30 minutes or 45 minutes. I like that the most to be honest, and I can build good rapport with my clients due to that.

What other outside hobbies and interests do you have?

My latest hobby is actually cycling. I picked up cycling at the start of the summer and I love it actually. I cycled the Gran Fondo, it's a race from Vancouver to Whistler, its 122 km, and didn't take too long. I was kind of happy with my progress. Trained a little bit, but could of trained a little bit harder. But I found a few little things that I might incorporate into my sessions with cyclists in the future, you know a lot of core. My core was kind of grumbling early on in the race, and a little bit of tingling into my left shoe as well. So have to address that but maybe that will be in another video.

And in the winter I like to ski in the mountains and there is not too many mountains in Ireland to be honest, so I only picked that up four years ago when I came over here. Started to do a few little jumps which is, I'm pretty impressed with after three years. A bit of an adrenaline junkie. I like the speed even though I know the injuries involved with that as well. So that's kind of a kind of funny as well.

I play hurling as well but I kind of gave that up two years ago, that's that fast sport I was telling you about earlier, kind of like a cross between lacrosse and field hockey. But lots of injuries in that too but I hope to get back into that in the Irish community as well so.

What’s your special interest or focus in treatment?

My special focus in treatment is mainly just educating the patients on the diagnosis, time lines, never keeping them in the dark but also mainly got to do with like pain modulation. You know people use medication like I spoke about earlier, I just don't think that, that's just a quick fix and the doctor is just getting you out of the office in a two minute consult. We deal a lot more with hands on. Mobility, nerve flossing, other techniques that kind of desensitize pain and different methods of pain modalities.

I heard a lot of bad stories about people just being put in a room and put on electrical machines and forgotten about. That's not how I work. I kind of do a bit of a combined method. Maybe some machine work, maybe some hands on, mobility and lots of strength and conditioning as well. Most of the research basically goes for strength and conditioning once the acute and sub acute stages have settled, that kind of where I'd be going, education on pain modulation is by far the most important thing and not relying on analgesics and surgeries if we can - avoid them.

Are there certain types of injuries that you’re more drawn to treating?

Yeah, particularly interested in the shoulder and the knee they are more so my specialty. I enjoy that. And there is lots of shoulder injuries in many many sports more because you're sacrificing mobility for stability, so that pretty enjoyable to me. And sometimes the neck as well we get a lot of sensation down into the fingers for different reasons. Anywhere sort of in the upper quadrant I kind of like.