Physiotherapy Questions, Answered

The first appointment is long enough for me to take a full history, examine you and explain what I have found before you leave, rather than a rushed slot. I will give you an honest estimate at the assessment rather than an open ended plan, and if you end up needing fewer sessions than I thought, I will say so.

No. You can book directly with us for private appointments. If you are using medical insurance, we recommend checking with your provider about their specific referral requirements.

Usually within a few days. We hold appointments until 9pm Monday to Friday plus Saturday and Sunday.

A conversation about what has been going on, a thorough assessment that looks beyond the painful area, a clear explanation, and a plan built around your goals.

Yes. Appointments run until 9pm Monday to Friday, plus Saturday and Sunday. For anyone commuting out of Gillingham that usually means you do not have to take time off, and the clinic is close enough that an evening slot is realistic.

Yes, we work with all the major providers including Bupa, AXA Health, Aviva and Vitality.

Sooner is better, ideally within the first week. Early assessment gets the grading right, which sets a realistic timeline, and stops the two common mistakes: resting far too long, or returning far too early. The clinic is in Rainham with evening slots, so it does not have to wait for a day off.

Current fees for an assessment and for follow up sessions are shown on the booking page, so you can see exactly what you are committing to before you book. If you would rather check we are the right fit first, the 10 minute call is free.

You see the same MACP accredited physiotherapist at every appointment, in a private treatment room, for long enough to be assessed in full. Nothing is handed over to a different clinician halfway through your recovery.

Yes, until 9pm Monday to Friday, plus Saturday and Sunday. Most commuters do not need to take time off work.

9 Eastwood Meadow, Rainham, Gillingham, Kent ME8 8FA, with dedicated parking directly outside. Easily reached from Gillingham, Chatham, Rochester and across Medway.

Roughly ten minutes from Gillingham town centre along the A2, and closer to five from Hempstead Valley.

Yes, dedicated parking directly outside the clinic. It sounds minor until you are travelling in with acute back pain and the alternative is a town centre car park and a walk.

Roughly fifteen to twenty minutes from Chatham, Rochester and Strood. Whether that is worth it is your call, but the appointment is long enough to get somewhere and you see the same physiotherapist every time.

Yes. The clinic is in Rainham and patients travel in from Gillingham, Chatham, Rochester, Strood, Hempstead, Walderslade and the surrounding villages.

Most straightforward episodes improve noticeably within two to six weeks once the plan is right. If you have had it for years it takes longer than that and I will not pretend otherwise, but you should understand what is driving it from the first session.

Usually not. Scans often show changes that are entirely normal for your age and do not correlate well with pain. Josh is trained to identify the small number of cases where imaging genuinely changes management.

Yes, and it is a large part of what we do. Persistent pain needs a different approach to a fresh injury, which is exactly what the assessment is for.

Sciatica is nerve pain, so it behaves differently: it travels below the knee, often with pins and needles, numbness or weakness, and it responds to positions that load or unload the nerve. The assessment includes neurological testing to establish whether the nerve is genuinely involved, because that changes the plan entirely.

Most of the sciatica I see settles substantially within six to twelve weeks. If you have had it longer than that it usually still responds, it just needs a more graded approach and a little more patience.

The large majority of people never do. Surgery is generally considered only where symptoms fail to respond over time or there is progressive neurological loss.

Usually yes, and often you should. The key is the type and dose, which is what the assessment establishes.

Massage reduces muscle tone and feels good, but it does not change how much load your back can tolerate. If nothing else changes, the tissue is back where it started within a week. Hands on work still has a place here, but as a way to make the loading part possible, not as the treatment on its own.

Almost always keep moving, within sensible limits. Prolonged rest tends to make back pain worse. Part of the assessment is working out what you can safely keep doing.

In most cases it settles well with the right management. The assessment establishes whether the nerve is genuinely involved and what is irritating it, so you know what you are dealing with from the first session.

Yes. Runner's knee treatment, meniscus tear treatment, knee replacement rehabilitation and ACL rehabilitation are all handled here, with the plan matched to the tissue and the stage.

Because the knee sits between them and takes the consequences of how both behave. A stiff ankle or a weak hip changes what the knee has to absorb every step. Treating only the painful joint is why a lot of knee pain keeps returning.

Often yes, with modification. Complete rest tends to reduce capacity further. The assessment establishes what dose your knee currently tolerates.

Yes, very commonly. Cervicogenic headaches originate in the upper cervical spine and often present as pain at the base of the skull spreading forward. They typically respond well to treatment directed at the neck.

Very. Most neck pain has no single moment behind it. Sustained postures, workload, stress and sleep all change how tolerant the neck is, and the pain often appears once tolerance drops below what an ordinary day demands. That is diagnosable and treatable. It just is not an injury.

Yes. Graded, guided reintroduction of movement is generally far more effective than rest or immobilisation.

Many rotator cuff changes are found in people with no pain at all, so a tear on a scan does not automatically explain symptoms. Most cuff related pain improves substantially with structured strengthening.

Frozen shoulder follows a recognised course that can run twelve to eighteen months if it is left alone. I am not going to tell you I can shortcut that, but the right treatment at the right stage makes a considerable difference to both comfort and movement along the way.

Shoulder pain frequently worsens at night due to sleeping position and reduced distraction. It is common and it is addressable.

Sometimes an injection helps create a window to rehabilitate. It works best alongside a loading programme rather than instead of one.

Usually not straight away. A knee scan rarely changes what treatment you need, and scans frequently show age related changes in people with no pain at all. A clinical assessment gives a clearer picture in most cases. See our knee pain page.

A fluid filled swelling behind the knee, usually secondary to something else going on in the joint. Treating the underlying knee problem is what settles it.

With the right loading most people notice a real difference within four to eight weeks. If I think yours will take longer, I will tell you at the assessment.

Pillows help some people and make no difference to others. It is worth addressing but rarely the whole answer.

Usually not. Shoulder scans very often show rotator cuff changes in people with no pain at all, so a scan on its own rarely tells you what is causing your symptoms. Clinical testing gives a clearer picture, and we will tell you if imaging would genuinely change the plan.

Running injury and overuse injury presentations are the most common, alongside hamstring strain treatment, calf strain treatment, groin strain treatment and general muscle strain treatment. Achilles tendinopathy physio and wider tendinopathy physio are a particular focus.

Yes. Post surgery physio and structured return to sport rehabilitation follow the surgical protocol, with objective testing before you go back rather than a guess.

Yes. Long standing injuries often haven't been assessed in enough detail. A fresh assessment frequently changes the whole approach.

Tennis elbow is a tendon problem at the outside of the elbow, usually from repetitive loading rather than a single injury. Like most tendon issues it responds to specific progressive loading and poorly to rest alone.

Pain under the heel, typically worst on the first steps of the morning. It is a load tolerance problem in the tissue under the foot and responds well to graded loading plus sensible footwear changes.

A catch all term for pain along the shin, usually from a rapid increase in running volume. Managing load while building tolerance is the fix, not stopping entirely.

The inside equivalent of tennis elbow, affecting the tendons on the inner elbow. Same principle: specific progressive loading rather than rest.

Both. A lot of what I see could have been picked up earlier, so I am happy to assess you before anything has gone wrong. That usually means looking at your training load, your movement and where your capacity currently sits against what your sport is asking of you, then building the conditioning that closes the gap. It is the same assessment, just done before the injury rather than after it.

Sports massage is generally geared around training and recovery, deep tissue focuses on sustained pressure through deeper layers to release long standing tension. In practice we combine both based on what you need.

Both. The difference from a standalone massage therapist is that the treatment is delivered by an HCPC registered MSK physiotherapist, so you also get an explanation of why the tension keeps coming back.

It depends what you want from it. For recovery around heavy training blocks, every two to four weeks suits most people. If you are coming because something specific keeps tightening up, the honest answer is that regular massage alone will not fix it, and we would rather find out why it keeps happening.

It can be intense in places but should never be unbearable. Pressure is always adjusted to what works for you.

Soft tissue massage, remedial massage, myofascial release and trigger point therapy, chosen for what the assessment finds rather than applied to everyone.

Not at all. Most of the people we see are dealing with desk based tension, general stiffness or simply want to move more comfortably.

Use it to understand what is going on, not to self diagnose. These answers describe patterns we see often, but the same symptom can have very different causes and the plan changes accordingly. If something here sounds like you, that is a good reason to get assessed, not a substitute for it.

Yes. Medical acupuncture is available as part of treatment where it is clinically appropriate, at our Rainham clinic.

Medical acupuncture uses fine needles to reduce muscular tension and pain. It is different from traditional acupuncture in its reasoning, but the technique overlaps. We use it alongside hands on treatment where it is clinically appropriate.

Yes. Widespread pain conditions need a different approach to a single injury, and a lot of what helps is understanding how the pain system has become more sensitive rather than chasing individual sore areas. We will be honest at the assessment about what physiotherapy can and cannot change.

Mainly time and continuity. Appointments are long enough to take a full history and examine you, and you see the same clinician every visit rather than repeating your story. We work alongside NHS care rather than replacing it, and will refer on where that is the right call.

That is one of the most common reasons people come to us. Usually it is because the assessment stopped at the painful area, or because treatment ended before the strengthening phase that makes the change stick. Josh will look at the whole picture and tell you honestly what he thinks is driving it.