MSK Physiotherapy

As a team we aim to promote, restore and maintain your physical capabilities, function and wellbeing. We provide specific advice and treatment to help you improve your function, return to your activities, and improve and maintain your quality of life.

Here at NHFT our physiotherapists are highly skilled, independent practitioners. Each specialises in their own areas of further learning and specific skill sets.

Musculoskeletal (MSK) physiotherapy relates to physiotherapy for the injured and/or problematic areas of the muscular and skeletal system. This includes:

• Muscles and tendons
• Joints, ligaments and cartilage
• Fractures / broken bones
• Nerves

Advanced Physiotherapist Practitioners (APPs) are highly specialised clinicians who work at a higher level of varied advanced practice. Skills include:

• Diagnostics* (such as x-rays, MRIs and blood tests)
• Injection therapy
• Independent prescribing
• Provision of a fit note (Med3)

* Please note, we cannot request diagnostics for anyone under the age of 18 years.

Our care for you as a patient of the MSK Physiotherapy service aims to give you:

1. A better understanding of your problem
2. Treatment to help resolve your physical problems
3. The ability to better manage your problem day-to-day
4. More confidence while living with your problem
5. Support to live a less limited life

During your appointment - the initial conversation

The most underrated part of your appointment is our initial conversation with you about your symptoms. This give us the foundations we need to help you most.

We want to know

1. What the problem is
2. How the problem is affecting you
3. What you have been through
4. How you want us to help you
5. What you want to achieve with physiotherapy

This allows us to build a picture of everything that has come before and helps us to make the next steps as effective as possible.

During your appointment - the assessment

We use this part of the appointment to confirm our diagnoses from the questions we have previously asked.

On completion of the assessment, we will

1. Fully explain our findings and your problem to you
2. Explain the possible options for your treatment

This allows YOU to be involved in each step of this assessment and allows us to provide the most successful and personalised treatment possible. This is based on the best and most recent clinical evidence and our own clinical experience.

To fully assess and observe how a joint or area of your body is working, we may need to ask you to undress that area of the body. If you don't feel comfortable to do so, please let us know.

If you would like to register yourself for the MSK Physiotherapy service you can do so in three different ways.

1. Complete a self-referral form (this cannot be used if your problem relates to your neck, back, hands, wrists or feet, or for women's pelvic health-related issues)
2. Contact your GP practice to book a first-contact physiotherapy appointment (if available)
3. Book an appointment with your GP to discuss referral to physiotherapy

Find out more about registering for MSK Physiotherapy

Before your first appointment, we've put together a check list for you to work through to help you be most prepared for your physiotherapy session.

1. We would recommend you take the NHS 'How are you' quiz online. This quiz is for over-18s and helps to give you a personalised health score. It's a 10-minute quiz, so grab a cuppa and spend some time focusing on you. 
    
2. Before you refer to physiotherapy think about your expectations or goals. Think about the following questions and consider writing your thoughts down.
   • What would you like to achieve from physiotherapy?
   • What would you consider as success from your treatment?
   • What would I do if I didn't have pain or this injury?
   • What hobby or activity would you like to take up as your activity levels and normal function start to return?
      
3. When you come to your appointment make sure you know your height and your weight. You can check your BMI on the NHS website.
    
4. Print and fill out a copy of our Musculoskeletal Health Questionnaire[pdf] 208KB before your appointment. It is important that you fill this out because it helps identify factors which may be contributing towards your pain and it allows our physiotherapists to keep a close eye on how well you are responding to treatment. If you don't have a printer, you can complete the form when you arrive for your appointment - but please make sure you arrive 5 to 10 minutes early so that you can do this before your appointment begins.
    
5. When you book your first appointment with us, please let us know whether you will need an interpreter or chaperone during the assessment, and let us know of any additional needs you may have.

Download and print a copy of this checklist

When you come to your first appointment a full check (also called a comprehensive assessment) will be completed by one of our trained Musculoskeletal Specialist Physiotherapists.

We will ask you a number of questions about:

• The history of your symptoms 
• Your past medical history
• Your past social history (including what you do for work and also any current or past hobbies)

We ask these questions to help us understand more about the current pain or issue. We can then also look at how we can identify what you want to achieve from the treatment sessions.

As well as asking questions, we will do a physical assessment with you. It is important you come in loose fitting clothing and the right type of footwear. We would recommend you wear trainers. To check the area giving you problem, we might ask you to undress or remove a piece of clothing to reveal the area.

If you would like another person in the room at the time, please just ask the therapist and will accommodate this for you.

You can expect our physiotherapists to explain what they have found, discuss contributing factors, how long your condition will take to improve and any available treatment options.

They may also speak to you about:

• Creating a bespoke rehabilitation exercise programme which will be available through the app
• Self-management advice 
• Booking a follow up appointment (if required) to check your progress towards agreed goals
• Increasing your activity levels or joining an exercise or activity class in your local community. Find out more about local activities[LINK TO #MSKPhysiotherapyfurtherinformation-MSKwellbeing]
• Ask you if there is anything we can do better! We are always looking to improve our service. If you have any ideas, suggestions, or feedback for us, please discuss it with your physiotherapist or complete a feedback form available online or from our reception desk

Magic Notes is a tool that helps clinicians create accurate, detailed notes from your appointment using a secure and private AI system. Instead of writing everything down by hand, your clinician can audio-record the conversation (with your permission). Magic Notes then generates a summary of the visit for them to review and edit. By reducing paperwork, Magic Notes gives clinicians more time to focus on you during your appointment.

Why do we use Magic Notes in physiotherapy appointments?

Magic Notes helps clinicians write clear and comprehensive notes more quickly. This makes follow-ups and referrals smoother and ultimately improves your care. Saving time on written note-taking, Magic Notes lets your clinician spend more time with you.

Does Magic Notes have to be used?

No - it's entirely your choice. Your clinician will only use Magic Notes to record a consultation with your permission. If you prefer not to have your conversation recorded, just let your clinician know and they will take notes as usual. You will never be pressured into agreeing to a recording.

Is my data safe?

Yes. Magic Notes has been rigorously checked for data protection and security compliance.

• Confidential and secure
  All information from your consultation is kept secure and confidential. Itstays within UK servers and is handled according to strict NHS data protectionstandards and UK law.
• No learning from your data
  Magic Notes does not learn from or train on your personal data - your privacyis a priority.
• Stored in your care record
  Magic Notes simply produces a summary note for your clinician to review and edit. The final note is then stored in your healthcare record just like any other clinical note. No Magic Notes data is ever stored on the recording device itself, only in secure NHS systems.

What does Magic Notes do - and not do?

• Creates a draft summary
  Magic Notes records the conversation (with consent) and produces a draft summary of what was said. Your clinician then reviews and edits this summary before saving it as a final note.
• Captures details
  Magic Notes helps capture what is said during your consultation, so nothing is missed, allowing for more accurate notes.
• Does not replace clinicians
  Magic Notes does not analyse your condition, give a diagnosis, or replace the expertise of a healthcare professional. All clinical decisions are still made by your clinician.
• Does not learn from or share your data
  Your data stays private. Magic Notes does not use your information to train any AI, and no data is shared with third parties outside of your care team or the secure systems needed to provide this service.

More information

If you have any concerns or questions about Magic Notes, please speak to your clinician. They will be happy to explain more and ensure you feel comfortable with whatever you decide.

Your care, your choice.

Thank you for helping us improve how we support you.

You can read more about how we collect, use and store data at Northamptonshire Healthcare NHS Foundation Trust in our privacy statement.

What is patient-initiated follow-up?

Patient-initiated follow-up (sometimes referred to as PIFU) puts you in control of making an appointment when you feel you need it, instead of having to attend a follow-up appointment which has been set for you and you may not need. It means you can have direct access to support when you feel you need it.

How does it work?

After your physiotherapy clinic appointment, your clinician will tell you if your condition is suitable for patient-initiated follow-up instead of regular follow-up appointments. Managing your appointments in this way is completely optional and it is your choice to go ahead with patient-initiated follow-up or not. If you feel it is not suitable for you, you can continue to book a scheduled appointment.

The patient-initiated follow-up service offers you an 8-week period of open access to the MSK Physiotherapy service as you need it. If you have not contacted us by the time the 8 weeks has ended, you will be discharged from our service and will need to contact your GP to be referred back to us.

How do I book an appointment?

If you have seen your physiotherapist, they will send you a text message containing a unique link to a website where you can make your next appointment. Please be aware that this link will expire after 8 weeks if no appointment has been made.

You can book your appointment up to 8 weeks in advance. Using the link, you will be asked to provide your date of birth and then you will be see a selection of appointments which are available to book with your clinician. You can also email us at patientcontactcentre@nhft.nhs.uk or call 0330 555 6789 to book an appointment or if you need a new link.

What if there are no suitable appointments available for me?

If you don't immediately see a suitable appointment time, please try your link again later as new appointments may become available.

If your link no longer works because it has expired, please contact us by emailing patientcontactcentre@nhft.nhs.uk or calling 0330 555 6789 to ask for a new link or for help with rebooking your appointment.

How do I check my appointment?

If you follow the patient-initiated follow-up link you have been given and type in your date of birth, your appointment should be available for you to see.

If you are having problems seeing your appointment or accessing the link, please email us at patientcontactcentre@nhft.nhs.uk or call 0330 555 6789.

Why doesn't my link work?

Your link may have stopped working if it has expired because it is only valid for 8 weeks. To request a new link please email us at
patientcontactcentre@nhft.nhs.uk or call 0330 555 6789.

How do I change or cancel an appointment?

You can cancel or change an appointment using the unique patient-initiated follow-up link you have been given.

You will see two options: 'Cancel appointment' and 'Rebook appointment'.

If you cancel an appointment, you will no longer be able to use this link and will need to contact us at patientcontactcentre@nhft.nhs.uk or 0330 555 6789 if you need another link or want to rebook.

Please note that you can only change your appointment using the link if the appointment date is more than 24 hours away. If your appointment date is within 24 hours of the appointment, you will need to contact us at patientcontactcentre@nhft.nhs.uk or 0330 555 6789 to cancel or rebook.

What happens if I miss my appointment?

If you do not attend your appointment, you may be discharged from the MSK Physiotherapy service. If you have any concerns, please contact us at patientcontactcentre@nhft.nhs.uk or 0330 555 6789 and we can explain what you need to do next.

Will I get a text reminder?

Yes, you will get a text message reminding you of your upcoming appointment.

When should I contact you for a patient-initiated follow-up appointment?

Once you have received your text message with your unique patient-initiated follow-up link, you will be able to book your appointment, either using the link or by contacting us at patientcontactcentre@nhft.nhs.uk or 0330 555 6789. You will have 8 weeks to make your appointment but you may need to request a new link in that time as the link expires after 8 weeks.

What if I don't need a follow-up appointment?

If you don't need a follow-up appointment, then you don't need to contact us. We will assume that you are better and a letter will be sent to your GP practice confirming you have been discharged from the MSK Physiotherapy service.

When is it not appropriate to use patient-initiated follow-up?

You should not use patient-initiated follow-up if you need urgent medical care or advice. Please contact your GP practice or use the NHS 111 service instead.

How long will I have to wait for my appointment?

You can book your patient-initiated follow-up appointment up to 8 weeks in advance, as long as your clinician has availability.

What happens when patient-initiated follow-up ends?

If we have not heard from you after 8 weeks, you will be discharged from our service. We will let your referrer know (your GP practice or your consultant) that you are on a patient-initiated follow-up pathway, and also when you have been discharged.

Can I come back after this?

If you have not contacted us within 8 weeks you will be discharged from our service and a new referral will be needed.

Can I give feedback on patient-initiated follow-up?

We are always grateful to receive feedback to help our service improve.

Complete our online feedback form

Email us

Call us: 0330 555 6789

Fibromyalgia is a long-term condition that can cause widespread pain throughout the body. People with fibromyalgia often feel pain in different areas, even though there may be no injury causing it. Pain can stay at roughly the same level or it can be changeable, which can be confusing for sufferers.

Along with the pain, many people experience extreme tiredness that may not get better with rest. Sleep can be disrupted but even a full night's sleep can still lead to waking up unrefreshed.

Fibromyalgia can also make it difficult to think clearly, concentrate, remember things or find the right words. This can be frustrating and can affect your daily life.

Some people also become more sensitive to touch, temperature, light or noise. You might notice that things that don't normally hurt - like a gentle touch - can feel painful. Fibromyalgia can also affect your mood, and it's common to experience anxiety or depression at the same time.

What causes fibromyalgia?

We don't fully understand what causes fibromyalgia, but we believe it's related to how the nervous system process pain signals. Essentially, the body becomes more sensitive to pain, even when there's no obvious cause. For some people, the condition seems to begin after a physical trauma, an illness, or a period of emotional stress. For others, it develops gradually with no clear trigger. It may also be partly genetic, as it can run in families.

How is fibromyalgia diagnosed?

There's no single test to diagnose fibromyalgia, so it's often diagnosed based on your symptoms and by ruling out other conditions. Despite the persistent nature of pain, it's important to know that it's not damaging your body or joints, and it isn't dangerous.

Living with fibromyalgia

Although fibromyalgia can be challenging to live with, many people find ways to manage their symptoms and lead fulfilling lives. You're not alone, and support is available - both from healthcare professionals and from others who are living with the condition.

Managing fibromyalgia involves finding the right balance between activity, rest, and self-care. While there's no cure, many people find relief through a combination of approaches.

• Regular exercise like walking, stretching, resistance training or yoga can help reduce pain and improve energy, especially when introduced gradually. The aim is to start small and gradually increase exercise levels. Avoiding exercise can lead to more pain and distress.
• Pacing your day - breaking tasks into smaller chunks with rest breaks - can help prevent flare-ups.
• Good sleep, managing stress levels, practising relaxation or mindfulness and addressing factors like diet, mood and wider health are also important.

You don't have to do all this at once! Support from healthcare professionals, including physiotherapists and pain specialists, can help you find what works best for you.

What to expect from the NHFT group fibromyalgia session

Our fibromyalgia group session can be accessed through a referral from your GP or consultant referral. It is designed to help you better understand your condition and explore practical, evidence-based ways to manage it. The session is educational, supportive and interactive, with input from healthcare professionals and space for participants to share their own experiences.

What the session will cover

• A clear explanation of what fibromyalgia is
• Common symptoms and how they can vary from person to person
• Possible causes and what can contribute to the condition
• An overview of the basic science of pain processing and how fibromyalgia affects the nervous system
• A focus on supported self-management strategies, including:
  • Managing flare-ups effectively
  • Graded exposure to exercise and activity
  • Pacing and energy management techniques
  • Identifying and addressing unhelpful lifestyle factors (e.g. poor sleep, stress, inactivity)

What to expect

• Input and guidance from healthcare professionals, including physiotherapy specialists
• Practical advice and tools that you can apply in everyday life
• The opportunity to share experiences and learn from others in the group
• A supportive, non-judgmental environment where questions are welcome

This session aims to improve your understanding, build your confidence, and support you in taking an active role in managing fibromyalgia.

Further information and resources

Pain management advice

• Flippin' Pain
• Fibromyalgia information booklet
• Live Well with Pain
• Tame the Beast
• Pain Toolkit - Pain Self Management
• The British Pain Society

Exercise advice

• Exercise - NHS

General health and wellbeing advice

• Better Health - NHS

Videos

Please note: this information is for people who have been referred to the pelvic health physiotherapy service by their GP or consultant. The service is only available to those referred by a healthcare professional.

What is pelvic health physiotherapy?

Pelvic health physiotherapy is a part of physiotherapy that helps with the health and function of organs in the pelvis, like the bladder, bowel, and uterus, as well as the muscles around them.

Our experienced physiotherapists can assist with issues such as leaking urine or stool, pelvic organ prolapse, and painful conditions in the pelvis, including vulvodynia, vaginismus, and pelvic pain.

These problems are often related to how well your pelvic floor muscles are working.

What can I expect at my physiotherapy appointment?

Your assessment will happen in a private room, and everything discussed will stay confidential. It's normal to feel a bit nervous before your appointment, but our team is here to help you feel comfortable and supported.

When you arrive, someone at Reception will welcome you and take you to the room for your assessment. To better understand your condition, your physiotherapist will ask you some questions about your symptoms, such as:

• When did your symptoms start, and what are they?
• Are there any activities or movements that make your symptoms feel better or worse?
• How many times do you go to the toilet during the day and night?
• How much and what types of drinks do you usually have?
• Have you had any tests or procedures for this issue?
• What medications are you currently taking?
• What do you hope to achieve through physiotherapy?

After going through these questions, your physiotherapist will talk with you about the physical examination, which may include an internal check-up.

What is an internal examination?

An internal examination is a way to check the health and condition of the muscles in your pelvic area. It can be done through the vagina or the anus. Your physiotherapist will first show you a model of the pelvis to explain what will happen during the exam.

The process is gentle, and we don't use any tools like speculums. We will only continue if you agree, and you can stop the exam whenever you want. You are welcome to bring a friend or family member with you, or you can ask for someone to be there with you for support if that makes you more comfortable.

What happens next?

Your physiotherapist will talk to you about what they found during your assessment, using pictures and models to make things clearer. Together, you'll create a treatment plan, which will probably include exercises tailored for your pelvic floor muscles and other related muscles. Feel free to ask questions anytime during your assessment. Your physiotherapist will usually schedule another appointment for you about 4 to 6 weeks later to check on how you're doing.

Further information

You may find the following leaflets and online resources useful.

• Patient information from the Pelvic Obstetric and Gynaecological Physiotherapy website
• Booklets and resources from the Pelvic Obstetric and Gynaecological Physiotherapy website
• Squeezy - a smartphone app reminding you to do your pelvic floor exercises and providing pelvic health advice and information (£2.99 download cost)
• Leaflets from the International Urogynaecology Association (IUGA) (variety of Languages available)
• Your Pelvic Floor website
• Bladder Health UK website
• Bladder and Bowel Community website
• Pelvic floor exercises information leaflet [pdf] 567KB
• Pelvic floor trauma information leaflet [pdf] 334KB
• Overactive bladder information leaflet [pdf] 336KB
• Pelvic Floor Breathing Exercises Leaflet [pdf] 268KB
• Pelvic Girdle Pain during pregnancy [pdf] 247KB

Most surgical wounds heal up rapidly without and problems. However, a minority of surgical wounds do become infected. This occurs when germs enter the cut that the surgeon makes through your skin in order to carry out the operation.

Many germs live in and on our bodies and also in our environment. Most are harmless or even useful. Our bodies have natural defences against the germs that can cause harm. Our skin normally prevents germs from entering our bodies, but any break in the skin (whether due to injury or surgical incision) can allow them to enter and cause an infection.

URGENT: Any suspected infection should be taken seriously. If it is left untreated it can progress into a much more serious problem.

Signs and symptoms

• The skin round your wound gets red or sore or it feels hot and swollen
• Your wound has a fluid discharge, often green or yellow coloured pus
• Your wound opens up
• You feel generally unwell or feverish, or you have a temperature.

If you experience any of the above symptoms, you should seek urgent medical attention at your GP or A&E at your local hospital.

Don't be put off by common terminology

You may have heard terms like these in relation to discs, joints or bones:

1. "Out of place"
2. "Slipped"

Research has clearly shown that what is described by these terms does not happen to discs, bone or joints in your back.

Anatomically, your back is a strong, stable structure which is capable of lots of movement. If a person experiences a severe episode of back pain when lifting, nothing has fallen out of place - even though it might feel like it!

Don't worry about what you read in MRI reports

When you have a scan the report will always show "stuff" (things like disc bulges, degeneration, dehydration and facet joint degeneration). However, research has shown this is rarely linked with pain.

People who have never had low back pain also have "stuff" on an MRI. This "stuff" can create a lot of worry that can distract from helpful activities like exercise. These things are normal parts of the ageing process - like grey hairs or wrinkles.

A scan is only essential if serious disease is suspected.

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Xplorer Challenge
Xplorer is a family friendly fun navigation challenge that's educational and gives children a sense of adventure as they explore parks to find the markers. It involves a healthy mix of physical activity and decision-making that the whole family can enjoy together.