Understanding our disciplines
One team, different hands
Worth saying to patients plainly: you're not being passed around because no one knows what's wrong — you're being matched to the right hands for what your body needs right now.
Tap a discipline
What each does, where it leads, when to hand off
The reasoning that ties it together
Why we sequence care this way
Progressing from calming an acute injury → active rehabilitation → graded strengthening is well-supported in musculoskeletal and whiplash recovery, and it's what our own practitioners have watched work over 10+ years of ICBC care: patients who move through a tiered plan do better long-term and feel more confident in their bodies again.
⏱ The ICBC 12-week timing point
ICBC's first 12 weeks include pre-approved sessions across disciplines, including kinesiology. Any extension beyond that is granted from a documented record of functional progress. If kinesiology is left until the very end, a patient can lose access to those sessions — or the file can be missing the progress record ICBC looks for.
So we book the kinesiology consultation early, even when acute symptoms mean active sessions start later. It costs the patient nothing, lets the kinesiologist confirm body mechanics on exercises already prescribed, and shows an extension was always the plan — not an afterthought.
This is a clinical decision, not a revenue one. The question is always: does this patient need this, right now?
A useful starting map
Where each discipline tends to lead
- Acute, joint-focused pain, especially spine → Chiropractic
- Recent whiplash / acute ICBC injury, easily aggravated → Massage Therapy (gentle first step)
- Can't lift, rotate, or return to an activity → Physiotherapy
- Chronic tightness or tension → Massage Therapy
- Plateaued — needs strength and confidence → Kinesiology / Physiotherapy
- Stalled for reasons that seem emotional, not just physical → Counselling
The whole person
Counselling is part of the team
Recovery isn't only physical. Fear of re-injury, frustration, and the emotional weight of a slow recovery — especially after a motor-vehicle accident — can stall progress as much as the injury itself. Bringing in counselling isn't a sign the physical treatment failed; it's a normal part of a well-rounded plan. A 2026 review of 11 clinical trials found counselling-based approaches (CBT, structured psychoeducation) measurably reduced anxiety, depression, and stress in whiplash patients, and improved pain, disability, and fear of movement.
In our building, outside the rehab team
Beyond the rehab team
Pointing a patient here is a referral out of the rehab team, not out of the clinic — usually right when a patient wants something the rehab team isn't built to give.
Manual Osteopathy — Ike Karunyasopon, DOMP
For a gentler, whole-body, holistic approach, or a complaint that doesn't map to one joint or muscle. Focus on seniors; gentle prenatal care. His exercise therapy is softer and more whole-body. Often not insurance-based (e.g. not ICBC-funded).
Dietetics — Sarah Boyd, RD
When nutrition is part of the picture — digestive, inflammatory, or cardiometabolic concerns, or eating patterns blocking a goal. Built around clinical need and a healthy relationship with food, not weight-loss coaching. Virtual Thursdays plus some in-person (arranged with her first).
Language that lands right
How we talk about this with patients
- No ranking. No discipline is more advanced or legitimate than another — the only question is fit to what the patient needs now.
- A handoff is the team working for them, not being passed around.
- Never frame multidisciplinary care as "more is better" or a box to check for insurance. It's timed and matched to need.
Notes & questions
Add a note, flag something that reads wrong, or ask a colleague. Your name is attached so we can follow up.
A shared way to build a plan
The treatment-planning framework
A good plan isn't a fixed recipe — it's a structure that keeps the patient's real life, goals, and barriers at the center. Every plan moves through the same five parts.
Prognosis & Outcome
Realistic recovery picture, shaped by the patient's beliefs and goals.
Phases
Calm & control → strength & stability → return to activity.
Milestones
Concrete, functional markers the patient can feel and see.
Progression Criteria
What has to be true to move to the next phase.
Frequency
Visit cadence built around the patient's real time and life.
The interview does the heavy lifting
Drawing out the patient's WHY
The more we understand what the patient needs to do, what's getting in the way, how they want to work, and why it matters to them, the more a plan actually gets them to their finish line.
Set 1 — Understanding the injury, the person, and the barriers
- "Walk me through what happened, and what you think caused it."Surfaces injury beliefs and fear of reinjury.
- "What movements make your body feel strong, and which make you nervous?"Separates physical from cognitive barriers to load.
- "When you picture returning to what you love, what part feels most concerning?"Targets specific fear triggers for graded exposure.
- "What do these activities give you outside of fitness?"Connects rehab to identity and motivation.
- "What have you tried so far — what helped, what didn't?"Informs reasoning and reveals self-efficacy.
- "What does a typical week look like — school, work, activity, recovery?"Reveals load-recovery balance and time barriers.
- "Who or what helps keep you accountable?"Identifies social support for adherence.
- "What's your ideal timeline, and what does 'ready' look like to you?"Frames phased goals and manages expectations.
- "How much time and energy can you realistically commit right now?"Guides frequency and home-program design.
Set 2 — Clarifying what they need to DO to reach the goal
- "What specific movements do you need to feel confident doing again?"Turns a broad goal into measurable tasks.
- "What does your body need to do, strength- or endurance-wise, to feel ready?"Reveals the capacity gap.
- "What would help you trust your body again when you push, cut, or land?"Brings confidence barriers into the open.
- "What might get in the way of being consistent over the next few weeks?"Surfaces logistical barriers early — before the plan is set.
- "What two or three things could you do each week to move closer?"Patient-led goal-setting builds ownership.
- "How would you like to track progress — feel, function, or numbers?"Co-creates outcome measures the patient is invested in.
- "What's one small thing you could start this week?"Builds momentum; becomes Phase 1's entry point.
Care is done with, not to
Patient participation in goal-setting
Patients reach goals more successfully when they help set them — it improves adherence, satisfaction, and outcomes. But research shows practitioners consistently believe in collaboration more than they actually practice it: the goal-setting step is the one most often skipped under time pressure. Woven into the interview from the start, collaborative goal-setting doesn't add time — it becomes part of the exam.
- Prepare the patient — explain what's happening and why, in their words.
- Clarify concerns — ask, then confirm you've understood, then prioritize together.
- Set goals together — state them out loud, in the patient's language, and write them down.
▸ Worked example — 23-yr-old with a mild meniscal injury, wants back to Ultimate frisbee
Fearful of loading and reinjury; goals are returning to Ultimate 2×/week and lifting 2×/week. From interview → plan:
| Framework part | Built from the interview |
|---|---|
| Prognosis | Excellent — mild injury, young, no instability. ~8–10 weeks; educate that hurt ≠ harm. |
| Phases | 1) Calm & control → 2) strength & stability → 3) agility → 4) return to sport. |
| Milestones | Full ROM by wk 3; split squats pain-free by wk 6; hop symmetry ≥85% by wk 9; confident scrimmage by wk 12. |
| Criteria | Advance on objective markers (ROM, limb symmetry, confidence), not the calendar. |
| Frequency | Busy student → 1×/week in-clinic + 2–3× self-directed with check-ins. |
Notes & questions
Add a note, flag something that reads wrong, or ask a colleague. Your name is attached so we can follow up.
Admin view
Team notes across all sections
Everything your team has flagged or asked, in one place. Individual practice debriefs (private to each person, visible to admins) arrive with the Interactive Scenarios module.