Interview: Jean-Paul Aubin-Parvu
Portraits: Orlando Gili
At Isokinetic, I look after a wide range of patients who are recovering from surgery or musculoskeletal injuries. They range from world class professional athletes from a wide variety of disciplines through to people who aren’t used to exercising at all. And based here in London, my work has an international feel, because our patients come from all over the world. With our multidisciplinary team of doctors, osteopaths, physiotherapists, hydrotherapists, movement coaches, onfield rehabilitators and clinical administrators, we welcome patients from the time of their actual injury all the way through to their full recovery.
My day starts quite early. I wake up at six in order to be ready to begin work at 7:30am. My shift is divided into two. During the morning I work in our hydrotherapy pool and then in the afternoon I switch to our exercise therapy gym. I feel very lucky to be able to work in two completely different environments, as this allows me to follow a wider range of patients through every stage of their rehab process.
Our rehabilitation environments are open spaces for therapeutic exercise, which means I provide one-to-one care in a group setting. This allows for a wonderful atmosphere for the patients. Each patient has their own specific programme and so at the start of the day I go carefully through the notes from their previous appointment to ensure that I offer them the very best treatment during this session. Our hydrotherapy pool is a unique environment. It has multiple floor levels and descends to a maximum depth of two metres. This is actually one of the few places in the UK that uses a pool as part of the rehab process. Many of my patients don’t really know what to expect from these sessions and usually have lots of questions about it, but having worked here for seven years I can guarantee them that the benefits are widely recognised.
Hydrotherapy sessions are hugely beneficial in the early stages of rehabilitation because they help to reduce pain and swelling, increase the range of motion in a joint and restore movement and function. Essentially, patients can move more and with less discomfort in water compared to what they can do on land, and this allows me to introduce certain movements and exercises earlier than I could do otherwise. Patients experience a decrease in mobility, strength and function following an injury or surgery and my primary aim in the pool is the early restoration of all three. I also use hydrotherapy sessions to treat patients who are at a later stage of rehab with the different goal of introducing landing, jumping and plyometric exercises. Sometimes these are the very movements that caused the injury, so the patient can be understandably scared of performing them again. It helps them psychologically to attempt them in a facilitating environment, and that also allows me to correct any biomechanical issue before the patient performs them on land using their full body weight.
The second part of my working day takes place in our gym. Patients start their sessions here during the acute phase, focusing on the management of swelling and pain and the recovery of range of motion. After that, the main focus in the gym is on restoring full strength. This is essential before the patient can progress to more dynamic movements. We need to ensure there’s no overload of the site of injury, to prevent re-injury. I like to challenge my patients to make the most out of each session. I assist them by making sure they perform exercises and movements correctly, and that there’s a constant yet safe progression throughout their rehabilitation process.
The most challenging aspect of my job is the fact that rehab is almost never a linear process. There are the inevitable ups and downs that occur along the way, and when those downs happen it can lead to some challenging situations. I see patients during a particularly difficult time in their life, perhaps after surgery or when they’re in acute pain, so my job isn’t just about my technical ability to treat the patient. It’s also about being able to maintain a positive environment where the patient feels constantly supported, encouraged and motivated. One key example is when I’m required to treat professional athletes who are dealing with the recurrence of an injury or with a surgery that could potentially end their career. To enable them to achieve a full recovery and get their careers back on track, it is crucial that I help these patients maintain a positive mindset throughout the course of the rehabilitation. Some injuries take many months to recover from. In every case, it is important that I clearly define the ultimate goal that my patient needs to achieve, but this goal can sometimes seem a long way away, which can demoralise the patient and hinder their progress. That’s why I always try to set and agree a constant flow of short-term goals with them. This helps the patient to stay motivated and maintain a positive attitude. When I treat a patient I always keep in mind the ultimate goal that they want to achieve, but every single session marks a small but important step towards it.
My job is never repetitive. Even if the injury or the surgery is exactly the same, every single person reacts to the recovery process in a slightly different way, both physically and mentally. I find myself perpetually learning and growing, both as a physiotherapist and as a person, and that is the most fascinating aspect of my work here. Having competed as a rhythmic gymnast for 13 years, I ended up seeing a physio from time to time and it was these sessions that sparked my interest in physiotherapy. I have always loved helping others and being a physiotherapist is a very practical way of doing that. It is hugely satisfying to see my patients reach milestones along their rehab journey, like being able to walk without crutches, going through their daily activities without suffering pain, or getting back to the sport they adore.
Ultimately, I love to see a smile returning to their face. I feel very proud of them for everything they’ve been able to achieve.
From Prognosis, The periodical of the Harley Street Medical Area Issue 07/2020
