02/03/2026
Surviving in the NHS as an MSK Physio 👀💭
I’ve worked in the NHS for years and in MSK since 2018 — and here’s the honest advice I’d give if you want to thrive, not just survive 💪
The NHS has its own system. Its own rhythm. Its own rules.
You have to respect that.
But that doesn’t mean you stop thinking differently.
At the end of the day, results matter.
Patients getting better matters. 👏
Here’s what I’ve learned patients quietly get fed up with:
🚫 Banded exercises for everyone
From my experience, they’re often overused and not always effective. If it’s not working — change it.
🚫 Handing out exercise sheets without checking
If you’re not testing, retesting, and watching them perform the movement… how do you know it’s helping?
🚫 “You’re just going to give me exercises aren’t you?”
That’s not about exercises.
That’s a patient saying: “I want to feel assessed. I want reassurance.”
🚫 Only treating the site of pain
“Yes, you were referred for knee pain.”
But we’re clinicians — think think bigger. Look at movement patterns, injury history, contributing factors. Treat the person, not just the body part 🧠

💡 What I’d suggest instead:
✔️ Check exercises properly. Test & retest.
✔️ Use exercise libraries or record videos on the patient’s phone.
✔️ Invest in CPD. Improve your strength & conditioning knowledge.
✔️ Use hands-on treatment strategically.
✔️ Take a holistic view — even within NHS constraints.
You can work within the system… and still elevate the standard 🔥
If you’re an MSK physio in the NHS — this one’s for you.
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