Inquisitive.me

You can’t help everyone. And that’s okay.

Sometimes, physiotherapy is not the final destination.

It is simply one station along the way.

Think about travelling by train. At some stations, you barely stop. At others, you step out, look around, get something to eat, and stay for a while. You might even return to the same place later and experience it completely differently.

Recovery can work in much the same way.

Some patients stay with me for several weeks or months. Physiotherapy is the right place for them at that moment. We work together, make progress, and gradually move towards their goals.

Others pass through.

Perhaps they need a more precise medical diagnosis before physiotherapy can meaningfully help. Perhaps several health conditions are interacting and one profession alone cannot adequately address the whole picture. Perhaps significant psychological distress is currently taking up so much space that exercises and physical rehabilitation are unlikely to be the most useful starting point.

Sometimes, physiotherapy can still contribute something.

But it may not be the most important station right now.

I recently worked with a few patients for whom this was the case. They initially thought physiotherapy was where they needed to stay. After talking, assessing, and trying to understand the bigger picture, I wasn’t so sure.

I had to tell them honestly:

“I do think physiotherapy could help with part of your problem. But I’m not convinced that it is the right focus at this moment.”

That does not mean their problem is “all in their head.”

It does not mean movement, training, or physiotherapy will never be useful.

It simply means that another part of the problem may require attention first—or alongside physiotherapy. Sometimes the better next step is psychotherapy. Sometimes it is another medical assessment. Sometimes it is support from several professions rather than the expectation that one person should solve everything.

And sometimes, I am simply not the right physiotherapist.

That possibility can be uncomfortable to admit.

As healthcare professionals, we naturally want to help. When someone arrives with a problem, we want to find the explanation, build the plan, and guide them towards improvement.

But wanting to help someone does not automatically mean that we are the person best equipped to do it.

Another physiotherapist may communicate in a way that resonates more with them. They may use a different treatment approach, notice something I missed, or offer the kind of support that person needs at that point in their life.

That is one reason why having different therapists with different experiences, hypotheses, and approaches is valuable. There is rarely one personality or one treatment philosophy that works equally well for everyone.

The same is true beyond healthcare.

Sometimes, you encounter the right thing at the wrong time.

I first read 1984 when I was about fifteen or sixteen. I thought it was unbelievably boring. The book only has around 250 pages, but in my memory, it felt closer to a thousand.

For years, I wanted to reread it, but I kept remembering how exhausting the first attempt had felt.

Then my book club chose it.

The second reading was completely different. I was older. I understood more about politics, society, and human behavior. I could see parallels that had been invisible to me as a teenager.

The book hadn’t changed.

I had.

It had simply reached me at a different station in my life.

Physiotherapy can be similar.

A patient may not be ready for the kind of active participation my approach requires. Their circumstances may not currently allow them to follow a rehabilitation plan. Another health problem may need more attention first. Or perhaps my way of explaining and treating things simply does not align with what they need.

That does not automatically make the patient difficult.

It does not automatically make my approach wrong.

And it certainly does not mean that physiotherapy has failed.

It may only mean that this is not the right station—or not the right time to stay there.

Perhaps they will return later with more capacity, a clearer diagnosis, or different priorities. Perhaps they will find another professional who is a better fit. Or perhaps physiotherapy will remain only one small stop within a much longer journey.

Our role is not always to take someone all the way to their destination. We have to take care of our own energy as well.

Sometimes, our role is to help them understand where they are, point towards the next connection, and let them continue their journey.

Sometimes, you are just a station along the way.

And that’s okay.

🧪 Let’s Experiment

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You do not have to be someone’s final destination to help them move forward.

The next time you feel stuck with a patient, resist the urge to immediately search for another exercise, explanation, or treatment technique.

First, zoom out.

🎯 Try This:

Ask yourself:

• Which part of this person’s problem can I realistically influence?
• What seems to be outside my role or expertise?
• Is physiotherapy the most useful station right now?
• Who might be better equipped to help with the next part of their journey?

Sometimes, the most valuable thing you can offer is not another treatment.

It is a clearer direction.

🧠 Final Thought:

Knowing when to guide someone onward is not giving up on them. It is part of helping them.

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