I have heard this question more times than I can count. A patient sits down in front of me, usually frustrated, often having already seen two or three physiotherapists with no lasting result, and asks: “What are you going to do differently?”
It is a fair question. And the honest answer is this: I am not going to start with your pain. I am going to start with your story.
That single difference starting with the story rather than the symptom is what separates sports physiotherapy from standard physiotherapy. And it changes everything about how an injury gets treated.
The back that was not a back problem
Let me give you a real example from my clinic in Saket, South Delhi.
A patient came to me with chronic lower back pain. He had seen multiple physiotherapists over the years. Each one had treated his back with ultrasound, TENS, massage, exercises for the lumbar spine. Each time he felt some relief however the pain returned within weeks.
When he came to me, I did something his previous physiotherapists had not done. I assessed his entire movement chain not just the area that was hurting.
What I found had nothing to do with his back. On one side, he had a pronated foot. His foot was rolling slightly inward with every step, changing the way force traveled up through his ankle, into his knee, through his hip, and finally into his lower back. His back had been compensating for this pattern for years. It was not the cause. It was the victim.
We strengthened the full chain foot muscles, calf, hamstring, glutes, and then the back. Once the base was strong and the mechanics were corrected, the back pain resolved. He had not needed more back treatment. He had needed the right assessment.
This is sports physiotherapy. The pain tells you where to look. It does not tell you where the problem started.
What “sports” actually means in sports physiotherapy
There is a common misconception that sports physiotherapy is only for athletes. It is not. The word “sports” refers to the standard of thinking applied to every patient not the patient’s occupation or fitness level.
In sports physiotherapy, the body is understood as a connected system. A chain. What happens at the foot affects the knee. What happens at the hip affects the lower back. What happens at the thoracic spine affects the shoulder. No injury exists in isolation. No treatment should either.
I developed this understanding through years of working with elite athletes. During my time with the Central Reserve Police Force as a team physiotherapist, I worked with wrestlers, boxers, weightlifters, and athletes who trained twice a day once for their service duties and once for their sport. Overtraining was the primary challenge. The body was under constant load. Understanding where the system was breaking down required looking at the whole system, not just the site of pain.
Later, during my field postings with ProHealth Asia to Australia, Hong Kong, Italy, and Germany, I worked alongside international physiotherapists across shooting, golf, rugby, and hockey. What I observed everywhere was the same: elite rehabilitation is exercise-based, strength-based, and chain-based. It is not machine-based. Ultrasound and TENS have their place. But they do not rebuild movement. They do not correct mechanics. They do not prevent the pain from returning.
The assessment difference
When a patient walks into most physiotherapy clinics in Delhi, the assessment typically focuses on the area of complaint. Back pain means back assessment. Knee pain means knee assessment. Shoulder pain means shoulder assessment.
When a patient walks into my clinic in Saket, the assessment starts with the history. Before I touch anyone, I want to know:
How did this start? Not just when, but how. Was there a single incident or did it build gradually? What makes it worse? What makes it better, even temporarily? What have you already tried? What helped, even a little?
The pattern in the history is often more revealing than the scan. I have seen MRI reports that showed significant findings in patients with minimal pain. I have seen MRI reports that showed minimal findings in patients with severe, debilitating pain. The scan shows structure. The history reveals function.
After the history comes the movement assessment. And here is where sports physiotherapy separates itself clearly. I am not just looking at the symptomatic area. I am watching how the whole body moves. How the foot hits the ground. How the hip loads. How the shoulder blade sits. How the thoracic spine extends. These patterns tell me where compensation is happening and compensation is almost always where the actual problem lives.
Why most back pain, knee pain, and shoulder pain comes back
The reason pain returns after standard physiotherapy treatment is usually one of two things.
First, the root cause was never identified. The symptom was treated. The symptom improved. The cause remained. Weeks or months later, the compensation pattern reasserted itself and the pain returned.
Second, the rehabilitation did not rebuild the base. Even when the cause is correctly identified, recovery is not complete until the supporting structures are strong enough to hold the correction. Strengthening the foot and calf and glute is not glamorous work. It takes patience. But it is the work that determines whether a patient stays well or keeps returning.
This is what I learned working within the multi-disciplinary sports science team at the Sports Authority of India in Sonipat alongside nutritionists, psychologists, and strength and conditioning coaches. At that level, rehabilitation does not end when pain stops. It ends when the athlete can perform their sport without compensation. The same principle applies to every patient, whether they are a national-level wrestler or a corporate professional with desk-related back pain.
What this means for you
If you are reading this because you have been dealing with pain that keeps coming back despite treatment, there is a good chance the root cause has not been found yet.
Sports physiotherapy in Delhi at least as I practice it in Saket means starting from the beginning. Not assuming the previous diagnosis was correct. Not treating the location of pain and hoping for the best.
It means listening to the story first. Because in my experience, the story always contains the answer. The pain just rarely tells you where to find it.
If you are dealing with a sports injury, post-surgery rehabilitation, or chronic pain that has not responded to standard treatment, I see patients in Saket, South Delhi. WhatsApp me at +91 92893 03555 to discuss what you are dealing with and whether I can help.
Dr. Manvi Dhyani, PT holds an MPT in Sports Physiotherapy from Jamia Millia Islamia and is a registered physiotherapist with the Delhi Council for Physiotherapy and Occupational Therapy (Reg. TPR-2666). She has worked as a team physiotherapist with the Central Reserve Police Force, completed international field postings with ProHealth Asia across four countries, and served as physiotherapist for India’s national archery team at the 2021 World Archery Youth Championships in Wroclaw, Poland. She practices in Saket, New Delhi.
Dr. Manvi Dhyani is a qualified physiotherapist (MPT Sports Physiotherapy, Jamia Millia Islamia; Registered Physiotherapist: Delhi Council for Physiotherapy and Occupational Therapy, Reg. TPR-2666). The title ‘Dr.’ is used in accordance with her doctoral-level physiotherapy qualification and does not denote a registered medical practitioner under the NMC Act, 2020.