Let’s Sort Those Aches: Your No-Nonsense Guide to Physio, Pilates & Body Whisperers

Decoding Physio, Pilates, Osteo & Chiro – Who does what?

Series: “Sorting Soreness: Your Guide to Physical Therapy & Rehab Tools” – Part 1 of 2

Right, let’s sort those aches. Whether it’s Physio, Pilates, or that mystical body whisperer with elbow powers — here’s who does what (and why it matters). 💥🧘‍♂️🦴

Right then. Ever feel like your body’s speaking a language you no longer understand? Less of a gentle whisper, more of a grumpy shout when you try to get out of bed? Tying your shoelaces suddenly feels like advanced Twister?

Welcome aboard. Hitting your 40s, 50s, 60s and beyond means your body’s carried you through decades. It’s only fair it asks for a little more care and attention now and then.

Here’s what 30 years of coaching people has taught me: those aches and twinges? They’re not a sign of collapse — they’re clever messages. “Oi! Pay attention. Something needs adjusting.” Ignoring them is like hoping a flashing dashboard light fixes itself.

But where do you turn when the creaks start singing? Beyond your GP, there’s a full squad of movement-focused professionals: Physios, OTs, Osteos, Chiros, Pilates instructors… It’s confusing. Who does what? What actually works?

This two-part series, “Sorting Soreness,” strips it all back to what matters: real insight, proper science, and the practical wisdom that helps you move better. Let's sort those aches.

🕵️‍♀️Physio: Your Body’s Movement Detective & Coach

Physiotherapy isn’t just for elite athletes or post-op rehab. It’s for everyday aches and injuries too. The Journal of Orthopaedic & Sports Physical Therapy and NICE guidelines both champion active, tailored exercise over passive treatment — especially for back pain.

What Physios Do Best

They assess how your body moves and pinpoint the root cause of pain. HCPC-registered physios use:

• Movement as medicine: Not just generic stretches — specific exercises for you.

• Skilled hands-on work: Joint mobilisations, gentle manipulations — used with care, never in isolation.

• Education: Understanding your pain reduces fear and boosts self-management.

• Pain neuroscience: Learning that pain ≠ damage is a game-changer.

Coaching Wisdom: Find a movement you enjoy. Consistency > intensity. Ditch the “no pain, no gain” myth — pain is a signal, not a target.

Example:

Sarah, 48, had stubborn shoulder pain. Her physio spotted muscle imbalances, prescribed targeted strengthening, used manual therapy, and — crucially — taught her how to stop it returning. That’s real physiotherapy.

☕️🛠️ Occupational Therapy: Making Life Work

Think OTs help you find a job? Nope. They help you do the things that matter, no matter what physical challenges you’re facing.

From dressing and cooking to working and socialising, OTs help restore everyday function using practical strategies and smart tweaks.

How OTs Help:

• Energy-saving hacks

• Joint protection techniques

• Clever tools and equipment (grabbers, ergonomic kitchen tools, bath aids)

• Home or workplace adjustments

Coaching Wisdom:

Many people resist using aids — it feels like “giving in.” But if opening a jar easier means you can still cook the dinner? That’s a win. OT is about independence, not defeat.

Think of physios as tuning the engine. OTs? They make sure the seat fits, the steering wheel’s comfy, and the gears are smooth so you can drive well.

🧘‍♂️🔩 Pilates: Core Precision & Controlled Power

Don’t be fooled by the calm tone — Pilates is serious movement training.

Developed by Joseph Pilates for rehab, it blends core control, alignment, breath, and awareness. And it’s brilliant for the 40+ crowd.

Why It Works:

• Core stability: Trains deep abdominal and spinal support muscles.

• Low-impact strength: Great for joints, arthritis, and injury recovery.

• Balance & posture: Counteracts desk slouching, improves coordination.

Coaching Wisdom:

Pilates isn’t about a “flat tummy” — it’s about building inner strength and resilience. Quality instruction is key, especially if you’ve got injuries. Start slow, ask questions, and make sure it feels right.

🤔🦴 Hands-On Help: Osteopathy & Chiropractic

These hands-on approaches are often lumped together — both use manipulations, especially for the spine — but their philosophies differ.

Osteopathy: The Whole-Body Engineer

Osteopaths believe in the interconnectedness of the body. They assess the whole system, not just the painful bit.

What They Do:

• Use soft tissue work, joint movement, and stretching

• Focus on restoring balance and alignment

• Look for issues elsewhere in the chain (e.g. sore knee caused by hip)

The Evidence:

Osteopathic manipulative treatment (OMT) shows benefit, especially for back pain, with effects that can last several months.

Chiropractic: The Spine Specialist

Chiros traditionally focus on spinal alignment and nervous system function. Their signature move? The spinal adjustment — a controlled, specific thrust often followed by a “pop.”

What They Do:

• Spinal manipulations

• Some soft tissue and rehab advice

• Focus on nervous system pathways

The Evidence:

Moderate-quality studies suggest manipulation helps reduce pain and improve function for chronic low back pain — about as well as exercise. Recent reviews say different styles of adjustment likely work similarly.

Osteo vs Chiro: Which is Better?

Short answer: Neither is objectively better — it depends on the practitioner and your needs.

Coaching Wisdom:

Choose someone who listens, explains things clearly, and reassesses regularly. Avoid miracle promises or big pre-paid packages without a clear plan. You’re not buying a car — you’re seeking care. The trust you build with a good therapist is worth more than any technique.

🎯 Final Thoughts: Let's Sort Those Aches

Your body isn’t broken — it’s communicating. The soreness is a signal, not a life sentence. With help from the right professionals, you can understand what’s happening, regain confidence, and move forward.

The best part? I’ve seen people of every age and background turn things around — not by ignoring pain, but by learning, adapting, and acting.

📣 Coming Up in Part 2:

We’ll explore the slightly more mysterious side of recovery:

• Massage (sports vs deep tissue)

• Acupuncture & dry needling

• Cupping, taping, and other alternative tools

All with the same no-nonsense tone, evidence-based approach, and coaching wisdom you need.

Stay tuned. Your toolkit’s just getting started.

When the brainstorming session gets serious… it’s time for the Thinking Cap. 💡🧠

✨ Don’t Stop Now — Your Muscles Aren’t the Only Things That Can Grow

🧱The Prerequisites for Strength (9-Part Series)

A foundational journey exploring what your body and mind need to build lasting strength over 40. Includes joints, bones, tissues, heart, hormones, and psychology.

🧠 More Than Muscle: What Mortality, Setbacks, and Superhumans Reveal (3-Part Series)

This series explores the deeper layers behind fitness — beyond sets and reps. It’s about the science of health, the stories of resilience, and the subtle clues that separate surviving from thriving.

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References

1. Chartered Society of Physiotherapy. (n.d.). What is physiotherapy?

2. Coulter, I. D., Crawford, C., Hurwitz, E. L., Vernon, H., Khorsan, R., Suttorp Booth, M., & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. The Spine Journal, 18(5), 866–879.

3. George, S. Z., Fritz, J. M., Silfies, S. P., et al. (2021). Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. Journal of Orthopaedic & Sports Physical Therapy, 51(11), CPG1-CPG60.

4. Licciardone, J. C., Brimhall, A. K., & King, L. N. (2005). Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders, 6, 43.

5. National Institute for Health and Care Excellence. (2016, updated 2020). Low back pain and sciatica in over 16s: assessment and management (NICE Guideline NG59).

6. NHS. A guide to Pilates.

7. NHS. Chiropractic.

8. NHS. Occupational therapy.

9. NHS. Osteopathy.

10. NHS. Physiotherapy.

11. Nim, C., Aspinall, S. L., Cook, C. E., et al. (2025). The Effectiveness of Spinal Manipulative Therapy in Treating Spinal Pain Does Not Depend on the Application Procedures: A Systematic Review and Network Meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 55(2), 109–122. Epub 2025 Jan 7.

12. Posadzki, P., & Ernst, E. (2011). Osteopathy for musculoskeletal pain patients: a systematic review of randomized controlled trials. Clinical Rheumatology, 30(2), 285–291.

13. Royal College of Occupational Therapists. About occupational therapy.

14. Royal College of Occupational Therapists. (2021). Professional standards for occupational therapy practice, conduct and ethics.

15. Steultjens, E. M. J., Dekker, J., Bouter, L. M., Van de Nes, J. C. M., Lambregts, E., & van den Ende, C. H. M. (2005). Evidence of the efficacy of occupational therapy in different conditions: an overview of systematic reviews. Clinical Rehabilitation, 19(3), 247–254.

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