The Banality of Ergonomics for Physiotherapists

If there’s one thing physiotherapists love, it’s telling people to sit properly.

We see a patient hunched over, and before they can say "it only hurts sometimes," we’re already adjusting their posture, prescribing scapular retractions, and mumbling something about lumbar lordosis. But when was the last time we applied this gospel to ourselves?

Personally, I would consider physiotherapists to be ergonomic hypocrites. We spend hours hunched over plinths, twisting ourselves into odd angles to mobilize a joint, or standing on one leg like a flamingo while demonstrating single-leg squats. And after all that, we go home with an aching back, sore wrists, and a nagging pain in the shoulder we pretend isn’t serious.

This is where ergonomic physiotherapy for physiotherapists comes in. Because if we’re going to preach about the evils of poor posture, we should at least try not to become our own case studies.

The Ergonomic Crimes of the Average Physiotherapist

We may not be hunched over office desks like the corporate zombies we treat, but let’s not fool ourselves, wee are not moving our bodies any better. If anything, our ergonomic crimes are even more ironic, considering we spend our days diagnosing movement dysfunctions while simultaneously setting ourselves up for one.

Our bodies are our tools, yet we move like we’re actively trying to wear them out. The "Manual Therapy Wrist Murder" is a prime example. After enough joint mobilizations and deep tissue releases, our wrists start to feel like they belong to a 70-year-old carpenter with a history of poor load management. We tell patients to protect their joints, yet we keep pummeling trigger points until our own hands stage a rebellion.

Then there’s the tragic dance where we lean, lunge, and contort to reach a patient instead of adjusting the plinth. We pretend it’s “just for a second,” but our lumbar spines keep the receipts. While we all vary in height, shape, and size, there’s one universal truth: plinth height matters. Treating at the wrong level is the quickest way to a lifetime of low back pain.

The Pose That Saves Your Back

There’s an art to moving as a physiotherapist without destroying your spine. The golden rule? Keep your spine neutral, engage your core, and let your legs do the work.

When treating a patient in standing, think athletic stance—feet hip-width apart, knees slightly bent, and weight evenly distributed. If you need to bend forward, hinge at the hips, not the spine. Your glutes exist for a reason; let them support you. If you're working in a seated position, make sure your hips are level with or slightly above your knees, with both feet firmly on the ground.

For manual therapy, avoid excessive reaching or twisting. Get as close as possible to the patient, adjust the plinth to a height where you don’t have to bend excessively, and—this one is critical—use your body weight, not just your hands.

Lean into movements rather than forcing them with isolated wrist or shoulder effort. If you’re treating a patient on a plinth, stand in a staggered stance rather than keeping your feet glued together. This gives you better balance, reduces strain on your lower back, and lets you shift your weight fluidly.

And for the love of all things musculoskeletal, bend your knees.

If you’re adjusting a patient’s leg or reaching for equipment, do a proper squat or lunge. Your lumbar spine should not be doing all the work.

The irony of a physiotherapist needing physiotherapy because they ignored their own advice is a little too on-the-nose. So, next time you catch yourself twisted at an unnatural angle, remember: you can’t fix patients if you break yourself first.