Are Kinesiologists And Physiotherapists More Similar Than Different?

One of the toughest questions any kinesiologist or physiotherapist can get is: 

‘What is the difference between a kinesiologist and a physiotherapist?’

Cue the internal eye roll and the big sigh - am I right?

I think my very favourite client responses when someone phones during our home based sessions and asks what the client is doing is, "I can't talk now, I'm doing physio with my kin." or "My kinesiologist is here to help me with my physio exercises." HOLY SMOKES 

It’s tough enough to describe this amongst ourselves as colleagues, but how might we simply explain this to clients or heck, even our family and friends, in 20 words or less?

Here’s some background information for us practitioners: 

Kinesiology was regulated by the Ministry of Health and Long Term Care in 2013 (so, like, yesterday) and physiotherapy was initially regulated under the Drugless Practitioner’s Act in 1924. Physiotherapy is almost 100 years older than kinesiology!

According to the College of Physiotherapists of Ontario, the regulatory body for physiotherapists, there are just over 10,000 physiotherapists currently practicing in Ontario. The College of Kinesiologists of Ontario, the regulatory body for kinesiologists, has approximately 3,000 kinesiologists on its register. There are about 7,000 more physiotherapists just in Ontario than kinesiologists!

Physiotherapists have a just a bit of a head start

So physiotherapists have understandably a bit of a head start being recognized by the public as treatment providers. When kinesiology is 100 years old I hope we are as prominent in Canada as physiotherapists!

Most regulated health care professions have one or more ‘controlled acts’ or authorized activities that they are trained to perform. These 14 controlled acts often assist to define a professions scope of practice.

Kinesiologists are not licensed to perform any controlled acts. Physiotherapists are licensed to perform seven. 

Does this ability for physiotherapists to perform controlled acts make their decision to pursue physiotherapy a wiser career choice than kinesiology because there may be more opportunities for employment? Maybe. Does it mean that physiotherapists, with advanced training in these areas, can command a higher salary than kinesiologists even if they don't perform these controlled acts in their practice? Perhaps.

The College of Physiotherapists of Ontario states that ‘a physiotherapist must roster (complete an online declaration) with the College if they perform any of the following controlled acts.’

• Spinal manipulation
• Tracheal suctioning
• Acupuncture (this includes dry needling)
• Treating wounds below the dermis by cleansing, soaking, irrigating, soaking, probing, debriding, packing or dressing
• Inserting a hand, finger, or instrument beyond the labia majora or anal verge for the purposes of assessing or rehabilitating pelvic musculature relating to incontinence or pain
• Administering a substance by inhalation (when the substance has been ordered by an authorized person)

Physiotherapists diagnose, kins form a ‘clinical impression’ or have ‘clinical or assessment findings’

Because physiotherapists are permitted to communicate a diagnosis which identifies a disease, physical disorder, or dysfunction as the cause of a person's symptoms they do not have to roster their skills here.

Personally, there is nothing in this list of controlled acts that I would like to do in my day to day practice. I can do mobilizations so I don’t feel like I am missing the ability to do manipulations. Frankly the majority of the controlled acts listed above I have NO interest in doing! However, if I knew that a client of mine would benefit from any of the techniques above, I would certainly refer them to a physiotherapist.

Now back to the ‘How the heck do I explain our professional differences to a client or a potential client?’.

We’ve explained what we don’t have in common, so let’s now look at what we DO have in common.

Our scopes of practice are understandably similar. Both are very broad and that’s a good thing. These scopes of practice do little to limit our ability to work with a wide range of people and conditions.

Kinesiology: “the assessment of human movement and performance and its' rehabilitation and management to maintain, rehabilitate or enhance movement and performance.”

Physiotherapy: “the assessment of neuromuscular, musculoskeletal and cardiorespiratory systems, the diagnosis of diseases or disorders associated with physical dysfunction, injury or pain and the treatment, rehabilitation and prevention or relief of physical dysfunction, injury or pain to develop, maintain, rehabilitate or augment function and promote mobility.

The biggest difference between the two scopes of practice is the word ‘diagnosis’ which we’ve already addressed above. Kins, like physios, are well experienced in the areas of physical dysfunction, injury and pain - which is a good thing because these are the big three motivators which bring us our clients!

Our core competencies are key

Where we can also look for further help to define us is our core competencies as healthcare professionals. Core competencies identify the essential skills, knowledge and perspectives on professional practice for our respective healthcare professions. As you can imagine, many of these competencies overlap. This is quite helpful because it is ideal that the public is treated the same way by all healthcare providers.

Physiotherapists have established eight clinical specialties:

• Cardiorespiratory
• Musculoskeletal
• Oncology
• Neurosciences
• Pain Sciences
• Paediatrics
• Seniors' Health
• Sport

Kinesiologists do not yet have any defined specialties and are unable to declare that they specialize in a particular area of professional practice. As we grow as a profession it is possible that we may develop special areas of practice with a focus on therapeutic movement.

Did you know? Kins can provide nutritional counselling! This is a big difference between our professions.

Interestingly, kinesiologists have nutritional counselling as a core competency and physiotherapists do not. Imagine the extra value kinesiologists are able to provide to our clients by addressing whole food nutrition, hydration, the avoidance of packaged and processed foods, adding a LOT more vegetables, choosing a wide variety of organic foods and eating simply three meals each day. The changes to our clients health could be significant. Much more on this area in upcoming blogs.

So, can we boil this down?

To bring this discussion back to our original question about the similarities and differences between the professions, let’s summarize the main points:

1. Kinesiology and physiotherapy scopes of practice are extremely similar.
2. Physiotherapists can diagnose an injury.
3. Physiotherapists and they have 14 controlled acts requiring advanced skills training while kinesiologists have none.
4. Physiotherapists have eight recognized clinical specialties and kinesiologists do not have any.
5. Kinesiologists have just a theory exam in order to enter regulated practice in Ontario at the moment whereas physiotherapy has a theory and a practical exam and is a regulated health care profession across Canada.
6. Kinesiology in Ontario is currently less than 10 years old whereas physiotherapy is almost 100 years old! This accounts for many of the differences because physiotherapy has had significantly more time to develop itself as a health care profession academically, in professional practice and through recognition by the public.
7. Physiotherapy is covered by FAR more extended health benefits insurers than kinesiology. But! We’re noticing that this gap is closing each year as kinesiology services are added to more and more employers’ benefits packages.

The cross overs, commonalities and differences

The challenge that kinesiologists and physiotherapists have when it comes to defining what we do is that there are SO many cross overs and commonalities that the definitions between the professions often lies in what the other is ‘not’ - in other words, what makes the two professions different.

We overlap very well - assessment, exercise prescription, use of electro therapeutic modalities like ultrasound, cupping and interferential current. We differ in that kins define their ideal clients not by trained speciality but by experience and an advertised focus.

So, what do we say exactly?

My best suggestion when working with the public and begin tasked with answering this challenging question is to say, ‘Kins and physios work well together. We have many overlapping skills and abilities. Physios have specialized training in a number of distinct areas as recognized by their professional College and are able to diagnose injuries. Kins form a clinical impression of your condition rather than a diagnosis. 

While both health care pros will assess you similarly, physios tend to concentrate more on passive manual therapies to manage pain and dysfunction whereas kins help your body move better with specific exercises to manage your pain and maximize your function.

In the clinical area of practice, physios often work with you during the more acute phase of an injury while kins will work with you during the injury prevention, sub acute or chronic stages of injury management.’

How do our treatment sessions compare?

I think it’s pretty common that, following a very similar physical assessment, physiotherapists tend to focus on more manual skills and assign home exercise programs whereas kinesiology tends to utilize a combination of manual therapy and exercise prescription during their sessions.

This difference is often because physiotherapy appointments are usually 20 to 30 minutes long and kinesiology sessions are commonly 60 minutes. Given the same time for a treatment session, unless the physiotherapist was performing a skill which was a controlled act, it would be difficult to tell the difference between our professions. And this is our identity challenge.

The commonalities between our professions are huge. The differences are very specific and are most easily seen when we examine the seven controlled acts granted to physiotherapists. When speaking with our clients, the larger picture of our similarities and differences needs to address our unique competencies, established with years of continuing education and experience.

Whatever your background, client care comes first. Have the skills? Great. Need back up? Refer to a colleague.

I’d love your feedback on our career differences. How do you explain kin and physio to your clients? Are we close??