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What is physiotherapy?
Physiotherapy, from the Greek kinesis (movement) and therapeia (care), is a paramedical discipline based on movement and manual techniques to restore, maintain, or improve the functional capabilities of the body. It is the leading paramedical profession in France by number of practitioners, with over 90,000 registered physiotherapists, nearly 85% of whom practice privately. Physiotherapy constitutes an essential pillar of the French healthcare system, playing a role in both post-operative rehabilitation and prevention of musculoskeletal disorders.
The history of physiotherapy in France dates back to 1946, when the State Diploma was officially created. The profession underwent a major reform in 2015, extending the length of studies from 3 to 5 years after the baccalaureate (one year of university selection followed by 4 years at an Institute of Physiotherapy Training). This reform aligned French training with European and international standards, strengthening skills in clinical research and diagnostic reasoning. In 2016, the Order of Physiotherapists was established to regulate the profession.
The physiotherapist is a full-fledged healthcare professional, holding a State Diploma (DE) and registered in the ADELI directory. Their title is legally protected: only DE holders can practice and use the title of masseur-kinesitherapeute. The profession rests on three fundamental principles: the physiotherapy diagnostic assessment (BDK), the development of a personalized care program, and ongoing evaluation of results. The physiotherapist acts on medical prescription within the coordinated care pathway, enabling reimbursement by Social Security.
The areas of physiotherapy expertise are vast: orthopedic and trauma rehabilitation, respiratory physiotherapy, neurological, pediatric, sports, perineal, vestibular, and cardiac physiotherapy. The physiotherapist uses a comprehensive therapeutic arsenal including manual techniques, active and passive exercises, electrotherapy, balneotherapy, and physical agents (heat, cold, ultrasound). This versatility makes them an essential player in the care chain, from infants to elderly patients.
How does a physiotherapy session work?
A physiotherapy session lasts an average of 30 minutes in the office, although some specialized sessions (neurological rehabilitation, respiratory physiotherapy) may last 45 to 60 minutes. The first consultation is longer: the physiotherapist performs a Physiotherapy Diagnostic Assessment (BDK), a comprehensive examination evaluating joint mobility, muscle strength, posture, balance, and functional capabilities. This assessment is sent to the prescribing doctor and forms the basis of the care program.
Manual techniques are central: passive and active-assisted joint mobilizations, muscle stretching, therapeutic massage (kneading, friction, drainage), myofascial release techniques, and muscle tension relief. The physiotherapist adapts pressure and intensity to each patient. In orthopedic rehabilitation, progressive active exercises (strengthening, proprioception, stabilization) are essential for restoring function.
Respiratory physiotherapy uses specific techniques: bronchial drainage, airway clearance, directed ventilation, and forced expiration techniques (FET). In infants, acceleration of expiratory flow (AFE) and provoked coughing help evacuate bronchial secretions. Vestibular physiotherapy employs repositioning maneuvers (Epley, Semont) and habituation exercises to treat positional vertigo.
The physiotherapist also has complementary tools: muscle electrostimulation (TENS, excitomotor currents), therapeutic ultrasound, cryotherapy, thermotherapy, pressotherapy, and balneotherapy. At the end of the session, home exercises are prescribed to extend the benefits of treatment. A complete rehabilitation program typically includes 10 to 20 sessions, at a rate of 2 to 3 sessions per week depending on the condition.
The proven benefits of physiotherapy
Physiotherapy has a solid base of scientific evidence. The French National Authority for Health (HAS) recommends physiotherapy as first-line treatment for chronic lower back pain, neck pain, knee osteoarthritis, and post-surgical rehabilitation. Studies show a 40 to 60% pain reduction after a complete rehabilitation program, with results comparable or even superior to medication for chronic back pain.
In respiratory rehabilitation, physiotherapy is essential in managing infant bronchiolitis, cystic fibrosis, COPD, and recovery from lung infections. A meta-analysis published in the Lancet Respiratory Medicine confirms that pulmonary rehabilitation (including respiratory physiotherapy) significantly improves exercise capacity and quality of life for COPD patients. In neurology, early rehabilitation after stroke increases functional recovery chances by 30%.
Sports physiotherapy reduces the risk of ankle sprain recurrence by 50% through proprioception programs. In post-operative care (knee and hip prostheses), rehabilitation accelerates the return to independence: patients receiving early physiotherapy walk on average 3 days earlier. Perineal physiotherapy, recommended postpartum, prevents and treats urinary incontinence with a success rate of 70 to 80%.
Beyond rehabilitation, physiotherapy plays a major preventive role: fall prevention programs for the elderly (30% reduction in falls), workplace ergonomics, musculoskeletal disorder prevention, and sports physical preparation. Patients who are active participants in their rehabilitation achieve better long-term outcomes.
What conditions can a physiotherapist treat?
Physiotherapy covers an extremely broad therapeutic spectrum. In rheumatology and orthopedics, it treats acute and chronic lower back pain, neck pain, sciatica, herniated discs, osteoarthritis (knee, hip, shoulder), tendinitis (rotator cuff, epicondylitis, Achilles tendinitis), sprains, fractures in the consolidation phase, scoliosis, and post-surgical recovery (prostheses, ligament repairs, arthroscopies).
In neurology, the physiotherapist intervenes in the rehabilitation of strokes (CVA), multiple sclerosis, Parkinson's disease, polyneuropathies, and facial paralysis. Neurological rehabilitation aims to restore motor function, balance, coordination, and independence in daily activities. In pediatrics, physiotherapy treats congenital torticollis, motor delays, spinal deformations, and infant bronchiolitis.
Respiratory physiotherapy is designed for patients with COPD, asthma, cystic fibrosis, bronchiolitis, and post-thoracic surgery. Perineal rehabilitation is indicated pre and postpartum, for urinary incontinence and organ prolapse. Vestibular physiotherapy treats benign paroxysmal positional vertigo (BPPV), vestibular syndromes, and balance disorders.
Certain contraindications must be respected: unconsolidated fractures, uncontrolled acute inflammation, active deep vein thrombosis, high fever, and certain skin conditions at the treatment site. The physiotherapist systematically evaluates these risks during the initial assessment. For serious pathologies (cancer, active infections), treatment is adapted in consultation with the medical team. Physiotherapy is suitable for all ages, from premature infants to the very elderly.
Physiotherapist training and regulation
Since the 2015 reform, the physiotherapy curriculum spans 5 years post-baccalaureate: one year of university selection (PASS, L.AS, or STAPS) followed by 4 years at a Physiotherapy Training Institute (IFMK). The training totals 6,400 hours, including 1,470 hours of clinical placements. The diploma awarded is a State Diploma (DE), recognized at master's level (Bac+5). There are 49 IFMKs in France, including 24 public and 25 private institutions.
The title of masseur-kinesitherapeute is a protected title: illegal practice is punishable by 2 years imprisonment and a 30,000 euro fine. Every physiotherapist must be registered with the Order of Physiotherapists and hold an ADELI number issued by the Regional Health Agency (ARS). The National Council of the Order ensures compliance with professional ethics and can sanction violations.
Continuing education is mandatory under the Continuous Professional Development (DPC) framework. The most sought-after specializations include sports physiotherapy (DIU), vestibular rehabilitation, orthopedic manual therapy, pediatric respiratory physiotherapy, and perineal rehabilitation. University diplomas (DU and DIU) complement initial training. On PratiConnect, each physiotherapist is verified: ADELI number, diploma, and Order registration are checked before profile publication.
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