Do You Really Need Weekly Private Physiotherapy Sessions – Insights From Chris Heywood Physio

To be fair, there are reasons the weekly-appointment model has survived longer than some dinosaurs. But let’s not pretend those reasons are all rooted in cutting-edge clinical science.

• Some are harmless.

• Some are convenient.

And some are about as subtle as the Ferrari parked outside the clinic with the personalised number plate “PHYSIO1”!!!!

Let’s break them down properly.

The Short Answer (Up Front)

1. It’s Familiar and Easy

Weekly bookings are simple. Nobody has to think too hard.

• The receptionist can auto-book you.

• The physio doesn’t need to explain a plan.

• You don’t have to ask awkward questions.

2. Some Patients Expect It

A surprising number of people genuinely believe physio works like a subscription service:

“I come every week, you do something to me, we see what happens.”

Clinics get used to this expectation and just… go with it. Comfortable for everyone. Not necessarily effective for anyone.

3. Some Business Models Depend on It

Here’s where the humour gets darker — because this bit really does happen.

Some clinics need high weekly appointment numbers to keep the lights on. You can often spot them because the red flags are almost comedic:

• A reception desk that looks like the lobby of a boutique hotel

• A “client success manager” offering you infused water

• The clinic owner’s extremely shiny sports car permanently parked outside

• A display of wealth management leaflets placed right next to the treatment room door

• A suspiciously enthusiastic offer of:“Our recommended pathway is a block of 10 weekly sessions — paid upfront.”

At this point, you may reasonably wonder whether you’re paying for treatment or for somebody’s quarterly bonus.

4. Habit Is a Powerful Thing In Private Physiotherapy

A lot of physios still practice the way they were taught decades ago:

• Weekly appointments

• Same sequence

• Same hands-on routine

• Repeat until morale improves

  
  

No one pauses to ask: “Does this person actually need weekly treatment?”

Habit fills diaries.Thoughtful planning empties them. Guess which one looks better on a spreadsheet?

5. Weekly Appointments Make Progress Look Like Magic

When you see someone every seven days, you get to claim credit for every natural fluctuation in their symptoms.

• If they improve:“Brilliant — that’s because of today’s work.”

• If they worsen:“Good thing we’ve got you in weekly.”

• If nothing changes:“We need more weekly sessions to shift this.”

Meanwhile, your injury looks the same… but your bank balance is noticeably lighter.

The Truth?

Most physios aren’t trying to mislead anyone. Many are simply working within a system that hasn’t been updated since the days when ultrasound machines were shaped like microwaves.

But convenience is not the same as best practice.

Weekly appointments should be a clinical decision — not a default setting.

Why This Question Comes Up So Often

Private physiotherapy is paid for directly by patients. That creates an unavoidable tension:

• Patients want to get better efficiently

• Clinicians need to run a viable business

Most physiotherapists manage this balance ethically. Some don’t- I won't liable myself anymore than that but understand like every profession, some have your best interests at heart, some have their own best interests at heart.

Importantly, frequency of treatment is not the same as quality of care. Seeing someone every week does not automatically mean better outcomes.

When Weekly Sessions Can Be Appropriate in Private Physiotherapy

There are situations where more frequent input makes sense, particularly early on.

Examples include:

• A new or acute injury where pain and function are changing quickly

• Post-operative rehabilitation with defined milestones

• Severe pain or movement restriction that needs close guidance initially

• Learning unfamiliar exercises or movement patterns safely

In these cases, regular sessions are usually:

• Time-limited

• Goal-driven

• Reviewed frequently

You should always know why you’re being seen that often — and for how long that’s expected to continue.

When Weekly Sessions Are Often Not Necessary

For many common musculoskeletal problems — such as long-standing back pain, knee pain, shoulder pain, or tendon issues — the evidence consistently shows that:

• Exercise, education, and self-management drive most of the improvement

• Progress happens between sessions, not during them

• Seeing someone weekly for passive treatment alone adds little value

Clinical guidelines increasingly recommend empowering patients rather than creating dependency.

In these cases, spacing appointments out — or even stopping regular sessions altogether — is often more appropriate.

What the Evidence Actually Says

High-quality research and clinical guidelines consistently support:

• Shared decision-making

• Individualised treatment plans

• Avoiding unnecessary ongoing passive treatment

For example:

• NICE guidelines for common musculoskeletal conditions emphasise education, exercise, and self-management rather than routine repeated appointments

• Research shows that patient outcomes are more strongly linked to engagement and understanding than treatment frequency alone

In other words, more sessions do not automatically mean better results.

Red Flags to Be Aware Of

It’s reasonable to question the approach if:

• You’re booked in weekly with no clear plan or end point

• Progress is never reviewed or measured

• Treatment feels the same every session

• You’re discouraged from doing things independently

• The focus is mainly on hands-on treatment with little explanation

None of these automatically mean you’re being “conned” — but they do warrant a conversation.

What Ethical Physiotherapy Should Look Like

Good private physiotherapy should involve:

• A clear explanation of what’s going on

• A rationale for how often you’re being seen

• Regular review of progress

• Willingness to reduce frequency as you improve

• Encouragement to become less reliant on appointments over time

In many cases, fewer, longer, more focused sessions are more effective than frequent short ones.

Why Some Clinics Default to Weekly Appointments

To be fair, there are reasons this model persists:

• It’s familiar and easy to schedule

• Some patients expect it

• Business models are often built around it

But convenience and habit are not the same as best practice.

So… Are You Being Conned?

Usually not. Occasionally, yes. Often, it’s simply that no one has stopped to ask whether weekly sessions are still necessary.

The most important thing is that you understand and agree with the plan.

If you don’t, it’s entirely reasonable to ask:

• “What’s the goal of weekly sessions?”

• “How will we know when to reduce them?”

• “What should I be able to manage on my own?”

A good clinician will welcome those questions.

Key Take-Home Messages

• Weekly physiotherapy isn’t automatically good or bad

• Frequency should always have a reason

• You should never feel pressured to keep attending without clarity

• Progress happens between sessions, not because of them

• Ethical care aims to make you less dependent, not more

If something doesn’t sit right, trust that instinct — and ask.