GRAHAM

SINCLAIR teaches Sports History and English for Physiotherapy on EUSES’ Sports Science and
Physiotherapy degrees. He also coordinates the EUSES ‘English as a Medium of Instruction’ programme. His
research interests include youth subcultures, corporeal identity in Sports Science, and fandom and identity in
football.
He has a bachelor’s degree in Modern European History from the University of Warwick, an MA in Popular Culture
from The Open University and his PhD in Cultural Studies was awarded by the University of Girona. His teaching
diplomas were awarded jointly by the RSA and the University of Cambridge (Language Assessment).
He has taught in various schools and universities in Spain, Portugal, France, Mexico, the Czech Republic, Brazil and
the UK.
 introductions

SPEAKING

Speaking 1 Work in small groups.

Write five or six questions which will help you get some information you would like to have about this
course and your teacher.

Q1 _____________________________________________________________________________________?
Q2 _____________________________________________________________________________________?
Q3 _____________________________________________________________________________________?
Q4 _____________________________________________________________________________________?
Q5 _____________________________________________________________________________________?
Q6 _____________________________________________________________________________________?

Take it in turns to ask your questions. Don’t repeat any questions which have already been asked.

Speaking 2 Discuss these questions with a partner.

• Why did you choose to study physiotherapy?

• What do you enjoy most about the course?
• What are your plans for the future?

Now, try to answer these questions.

1. What is physiotherapy?
2. Is physiotherapy the same as physical therapy?
3. What do you call a health care professional who practices in the field of physiotherapy?
4. What are the main specialty areas in physiotherapy?
5. What treatments do physiotherapists use?
6. Where are physiotherapists likely to work?
7. Who will their patients be?
8. What training programmes do you have to complete to work as a physiotherapist?

Here are some possible answers to the questions you were discussing.
Try to match them with the questions.
a) A health care profession that helps people to move. It provides treatment to restore and maintain
maximum movement and function in patients with physical problems caused by disease, injury or
ageing.
b) A physiotherapist or informally, a physio. In the U.S. they are known as physical therapists (PTs).
c) A 3 year university programme leading to a Bsc in physiotherapy is the first step, which may be
followed by a 2 year master’s programme and a doctoral programme.
d) Cardiopulmonary rehabilitation, geriatric physiotherapy, neurological physiotherapy, orthopaedic
physiotherapy, sports physiotherapy and paediatric physiotherapy.
e) Manual therapy such as massage and manipulation, therapeutic exercise, electrotherapy and
cryotherapy.
f) People with neurological disorders or disease, disorders of the musculoskeletal system,
cardiopulmonary disorders, the elderly with reduced mobility and fitness.
g) Physical therapy is the U.S. term for physiotherapy.
h) These places include hospitals, nursing homes, physiotherapy gyms, rehabilitation clinics, fitness
centres and sports training facilities.

✓ Where do you think this picture was taken? Why?

✓ What’s happening in the picture?
✓ How do the people feel?
✓ Does it remind you of anything you’ve done recently?

WATCH

You Can Be Me - A Career in Physical Therapy

(https://www.youtube.com/watch?v=r35FQT3u0J4)

In this short film you are going to see different therapists working in different situations.


GRAMMAR FOCUS

PRESENT TIME

There are two basic verb tenses used for expressing present time in English – the Present Simple and
the Present Continuous.

We tend to use the Present Simple for states, habits and regular actions (often with adverbs of
frequency).
I live in Barcelona.
She plays tennis.
They never arrive on time.
For explanations and practice of the basic form, you can look here:
https://learnenglish.britishcouncil.org/en/english-grammar/present-simple-basic
The present continuous is used to express actions which are happening now:
I am watching television. (Right now)
Or around now:
She is reading a good book at the moment. (The book is on the table next to her bed)
For explanations and practice of the basic form you can look here:
 https://learnenglish.britishcouncil.org/en/english-grammar/present-continuous-basic
Careful! Some verbs do not take the continuous form. Generally these verbs do not describe
actions. They tend to describe states or the way we feel about things. They are usually called
stative verbs.
Here are some examples:
agree, be, believe, belong, depend, forget, hear, know, like, love, matter, mean, need, prefer,
realize, seem, want

So, ‘I agree’ is fine but we cannot say ‘I’m agreeing’.

‘It doesn’t matter’ is fine but we cannot say ‘It isn’t mattering’.

REMEMBER
Some verbs can be both stative and dynamic depending on how they are used. Think about these two
sentences:
I see what you mean.
I’m seeing my physio tomorrow.
In the first sentence ‘see’ means ‘understand’ and cannot take the continuous form.
In the second sentence ‘seeing’ means ‘meeting for an appointment’. It’s an action and can take the
continuous form.
For a more complete list and details of stative/dynamic verbs, have a look at: https://www.perfect-english-
grammar.com/stative-verbs.html
In many languages we can use present tenses to talk about the future.
• In English the Present Simple can be used to talk about things which are timetabled to happen in
the future. This is particularly useful for travel and public events.
My train leaves at three o’clock tomorrow afternoon.
The conference starts at 9am on Monday.
• We can use the Present Continuous to talk about future plans and arrangements.
I’m playing tennis on Tuesday.
We’re having a party on Friday, do you want to come?
If you think you need some practice here, have a look at: https://www.flo-
joe.co.uk/preliminaryenglish/grammar/present-simple-and-continuous-as-future-tenses.htm

Choose the best verb form and say why it is correct.

1. Where do you come / are you coming from?
2. Where do you study / are you studying at the moment?
3. What do you like / are you liking about your studies?
4. What do you do / are you doing in your free time?
5. Why do you learn / are you learning English?
6. How often do you watch / are you watching a film in English?
7. Do you watch / Are you watching a series at the moment?
8. Do you see / Are you seeing your family at the weekend?
9. Do you ssee / Are you seeing your family at weekends?
10. Do you belong / Are you belonging to any social networks?
Check your choices with a partner and with your teacher.

Work with someone you don’t usually work with and ask and answer the questions.
Look at these pictures of physiotherapists working with their patients.
✓ Are you familiar with these exercises?
✓ With a partner describe what they’re doing.
✓ Why do you think they need this treatment?
✓ Have you ever had or given treatment like this?
Have a look at these sentences – decide if they are right (R) or wrong (W). Correct any mistakes you find.

READING

My Life as a Physiotherapist
Every month here at Corby General Hospital we speak to a member of staff to let you know about the
different things we do. Today we are speaking to Molly Chase, a physiotherapist who is specialised in
children’s health.

Why did you decide to become a physiotherapist?

When I finished my A levels I knew (EX) ___0__ but I didn’t have the grades to study medicine. My brother
plays tennis and (1) _____ after a serious injury. He thought I could be a good physio so I tried to find
some information. I liked the idea that you could work in a variety of settings and that (2) _____ my
specialism too early. So I studied at Edinburgh University, did an Erasmus in Catalonia and then came
here at CGH and did my rotations.
And why did you decide to specialise in children?
It’s funny – (3) _____to work with athletes but when I was working with kids during my rotations I fell in
love with the idea. Many of the conditions we have to deal with are the same as with adult patients but
communication (4) _____. It’s really important to work closely with the families and that’s something I
really enjoy. More and more we follow the children back home and try to work out treatment programmes
for them there.
So what type of conditions do you have to deal with?
As I said, a lot of the conditions are the same as with adults – we help our patients recover strength,
mobility and balance after accidents and injuries but (5) _____ whose physical development has been
affected by illnesses and other conditions. I’ve just finished a course in respiratory physiotherapy and I
work with patients who have acute and chronic chest conditions – we try to clear secretions, improve
breathing and generally help them lead normal lives.
What are the best and worst things about your job?
I like it when I feel a bit like a detective and I use the symptoms as clues to try and build up the correct
treatment programme. Of course, (6) _____ having a positive impact on our patients lives. Last week I had
a girl who walked without crutches for the first time since a car accident – you can imagine! I hate it
when I make a wrong diagnosis or when the treatment I’ve suggested just doesn’t seem to work. But I
think the most difficult thing, especially with children, is when you know deep down that there’s nothing
you can do for them – that’s really tough.
What advice would you give to someone who was thinking about becoming a physio?
It’s really important to be sure that (7) _____. I’d go in to a local hospital and ask to speak to one of their
physios. Here at CGH we have open days and we let school students shadow members of our staff for a
day if they’re thinking about a career in healthcare. The other thing to remember is to keep an open mind
– most people usually decide when they have done their rotations. It’s hard work and (8) _____ getting
emotionally involved but the rewards are huge.
Some phrases have been removed from the text. Choose the best phrase to fill the gaps where they are
indicated. There is an example. There is one answer you do not need to use.

 PRONUNCIATION - Quick focus!

You know that we need to add an ‘s’ in the third person singular of the Present Simple. But did you
know that sometimes this ‘s’ is pronounced like ‘is’?
Here is a list of sixteen verbs related to health. Divide them into two groups. Which verbs need the ‘is’
sound?
analyse • help • control • panic cure • catch • relax • inject increase push • scar • release treat • change •
examine • crash

SPEAKING

Take some time to prepare the questions you’re going to need to ask for this activity.

Find someone who...
Name Extra information
has the same tutor as you. _______________ ________________________________

likes the same subjects as you. _______________ ________________________________

would like to live abroad. _______________ ________________________________

has broken a bone. _______________ ________________________________

is married. _______________ ________________________________

has played a sport for their country. _______________ ________________________________

has a big family. _______________ ________________________________

is a good cook. _______________ ________________________________

has a strange hobby. _______________ ________________________________

has been treated by a physio. _______________ ________________________________

has been on television. _______________ ________________________________

plans to open their own practice _______________ ________________________________

failed an exam in the first term. _______________ ________________________________

loves studying English. _______________ ________________________________

is going to the gym this evening _______________ ________________________________

WRITING

An informal email
You are a first-year physiotherapy student planning to study in the United Kingdom next term.
You have received the following email from your future flat-mate:

Write an informal email in response to Sheena’s email.

In your email you should:
• Describe your life at the moment
• Say what sports you do and what hobbies you have
• Talk about your plans and why you want to study in the UK
Write your answer in an appropriate style in 160-200 words

FOCUS

Organ Systems of the Human Body

Different organs can work together to perform a common function, like how the parts of your
digestive system break down food. We refer to an integrated unit as an organ system. Groups of
organ systems work together to make complete, functional organisms - like us!
Match the different systems with their components and pictures.

 What does each system do?
Make some notes as you watch the video.
Introduction To Anatomy Physiology: Organ Systems
(https://www.youtube.com/watch?v=HIZIKLSY9mM&t=106s)

Cardiovascular

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GRAMMAR

STYLE TIPs

Remember we don’t have different versions of the word ‘you’ in English but we do have a variety of
ways in which we can make our language more or less formal. This often involves the vocabulary we
select but sometimes we make grammar choices too.
If you want to make questions and requests sound a little less direct, try using polite openings. There
are lots of these but you only really need two or three.
Three direct questions Making things less direct

Where do you live? Could you tell me where you live, please?

What’s the problem? I’d like to know what the problem is.

How old are you? Would you mind telling me how old you are?

REMEMBER

These are easy to use. Just remember that you don’t need to use a question form in the second part
of the sentence and that after ‘mind’ you need a gerund.
Correct the mistakes in these sentences.

1. Could you tell me where do you live?

2. I’d like to know what medication are you taking.

3. Would you mind to sit down, please?

4. Could you tell me if are you in pain?

5. I’d like to know when did you have the accident.

6. Would you mind breathe in deeply?

 Try to make these questions a little less direct.

1. How much do you weigh?

2. How old are you?

3. Do you smoke?

4. How much exercise do you do every week?

5. Do you have any allergies?

Practise asking and answering these questions with a partner.

We can also use these structures for giving instructions.
Try to make these sentences more polite and then practise them with your partner.

1. Stand up.

2. Sit down.

3. Lie down.

4. Raise your arms above your head.

5. Touch your toes.

Now do some more practice using all of the questions and instructions with a new partner.

For some extra reading about speaking to patients and especially about taking patients’ histories, have
a look at: https://www.researchgate.net/publication/5610987_A_guide_to_taking_a_patient’s_history

VOCABULARY

In this table there are 26 words for parts of the body and six categories. Decide which category or
categories each part belongs to. The first one has been done for you as an example.


 the human skeleton

THE SKELETAL SYSTEM

Speaking 1 Discuss these questions with a partner.

• What would you say were the main functions of the human skeleton?
• How many bones do you think there are in the human skeleton?
• What are the four basic bone shapes?
• What are some of the qualities of compact and cancellous bones?

Now watch the Crash Course in The Skeletal System (https://www.youtube.com/watch?v=rDGqkMHPDqE)

As you watch make a note of any key vocabulary you think might be useful – you will be tested on this.

Have another look at the discussion questions. You should be able to expand your answers.


VOCABULARY

The skeleton of an adult human is made up of 206 bones. When we are talking about these in
English there are often two words we can use. The word with a Latin origin usually sounds more
technical and formal. Try to complete these short paragraphs.
If you have problems, you should be able to find what you need here:
https://training.seer.cancer.gov/anatomy/skeletal/

The Axial Skeleton

This includes the skull and the bones of the trunk: the vertebral column, rib cage and breastbone or
(1) s___________). The cranium is the top part of the skull and is made up of eight bones. Fourteen other
bones make up the skeleton of the face. The only moveable bone in the skull is the (2) m___________ or
lower jaw bone. The vertebral or (3) s___________ column consists of 33 vertebrae. The rib or
(4) t___________ cage is formed of 12 pairs of ribs with the top 7 pairs of ribs attached directly to the
breastbone and known as true ribs. The next 5 pairs are called false ribs because they are not joined to
the sternum but are attached to the costal cartilage. The 11th and 12th, called floating ribs are not
attached at the front at all.
The Appendicular Skeleton
The appendicular skeleton consists of the bones of the upper and lower limbs or (5) a_____ and l_____
along with the bones that attach them to the axial skeleton.
The shoulder girdle is formed by the (6) c_______________ or collarbones and the scapulae, or
(7) s______________. It supports the upper limb attaching its skeleton to the axial skeleton. The bone of the
upper limb is called the humerus. The radius runs from the elbow down to the wrist on the thumb side
and the ulna joins the wrist on the other side. The wrist contains eight bones called the carpals which are
attached to five metacarpals. Each set of fingers has fourteen bones known as phalanges.
The pelvic girdle consists of the right hip bone and the left hip bone and connects the lower limbs to the
axial skeleton. Each lower limb has 4 bones. These are the femur, or (8) t_________ bone, the
(9) p__________ , or kneecap, and 2 bones in the lower leg which are the tibia, or (10) s__________ bone
and the fibula. These along with the talus make up the ankle joint. The foot has a complicated mechanical
structure containing 26 bones in total, 33 joints, and more than a hundred muscles, tendons, and
ligaments.

GRAMMAR FOCUS
PAST TIME
When we are talking about things which happened in the past, we usually use what are often described
as the narrative tenses.

We tend to use the PAST SIMPLE to talk about complete past actions and situations.
When I was younger I lived in Paris.
Regular verbs are easy – you just add ‘ed’ but you need to remember the irregular verbs.
For explanations and practice of the basic forms, you can look here:
https://learnenglish.britishcouncil.org/en/english-grammar/past-simple
We use the PAST CONTINUOUS to talk about incomplete past actions and situations. This often gives
us background information.
I was living in Prague when I met him.
She was playing football when she sprained her ankle.
This isn’t too complicated you need to use the verb ‘to be’ in its past form (was/were) and the verb in its
‘ing’ form.
For explanations and practise of the basic forms, you can look here:
https://learnenglish.britishcouncil.org/en/english-grammar/past-continuous
We use the PAST PERFECT when we are talking about actions which happened before another action
in the past. This can be a complete (SIMPLE) or incomplete (CONTINUOUS) action or situation.
He had won three championships when he decided to retire.
 I had been waiting for an hour when she arrived.
For the simple form use ‘had’ and the past participle (third column). For the continuous form use ‘had
been’ and the ‘ing’ form.
For explanations and practice of this, have a look at: https://learnenglish.britishcouncil.org/en/english-
grammar/past-perfect
Sometimes we don’t need the PAST PERFECT for sequencing past events.
Look at this sentence.

The crowd cheered when the referee blew his whistle.

Here we know that one action follows another action immediately. First, the referee blew his
whistle and then the crowd cheered straight away.

TIME FOR A CHAT
Work with a partner and answer the following questions:

PAST FORMS PRACTICE

Complete these sentences with the past simple, used to, past continuous or past perfect form of the verbs
in brackets

1. What do you do now that you’ve retired? I play a lot of golf. I didn’t use to like it but I’m a big fan.
2. He has just run a marathon. When _____ he _________ training? (start)
 3. Where were you at ten this morning?
4. Why did the referee send you off?
5. I haven’t seen Rob at the gym recently.
6. Why didn’t you recognise her?
7. He was singing when we arrived.
8. Can you remember hearing the news?
9. Did she react quickly?
10. Was it a sudden decision?
11. Have you always worked here?
12. Has she been ill for long?
13. He seems like a natural in the job.
14. How are you feeling today?
15. When did you decide to leave?
I _______________ breakfast at home. (have)
Because I ____________ the correct shirt. (wear)
No, he _________ his leg last month. (break)
Because she ___________ so much weight. (lose)
He ______ already _______ four cocktails. (drink)
Yes, I _____________ for an exam when I heard. (revise)
Yes, as soon as she ____________ the shot, she
_____________ to the left. (see, dive)
Not really, I ______________ about it for a while before I
__________ it. (think, buy)
No, I ________ three years in Italy when I first _______.
(spend, start)
Well, she first __________ the symptoms when she
_______ on holiday last summer. (recognise, be)
That’s strange! He __________ a boxer before he ________
a physio. (be, become)
Generally speaking, I’ve been feeling better since
I ________ smoking. (stop)
When I ________ how they __________ their money.
(realise, made)


READING

You are going to read a blog post in our series ‘What would I do if I met her now?’ Alice Chilton
tells us about an injury she had when she was playing football for her university team.
Five sentences have been removed from the post. Choose from the sentences A-E the one which fits each
gap (1-5). There is one extra sentence which you do not need to use. There is an example at the
beginning (0).

So what would I do if I met her now?

It feels like an eternity but it only happened about ten years ago. I think about it quite often but I’m sure
that out there somewhere, the young woman who changed my life never gives the incident a moment’s
thought. It was a bright Sunday morning just before the Easter holidays. I was playing for our university
football team when I found myself rolling around on the ground clutching my shin. (0) I was to learn
later than I had suffered a compound fracture of my tibia.
I had picked up the ball on the halfway line and seen that Jan, my room as well as team-mate, was
running hard about ten metres to my left. I played a through ball hoping she’d return it once I was behind
their defence. The ball arrived and as I stretched a leg for it, I realised that one of their defenders had
read the move. It was a fifty-fifty ball and I heard a loud crack as we crashed into each other. I remember
thinking that someone must have broken something. It was only when I tried to stand up that I realised
that the someone was me. I fainted. Later my coach told me that my shin bone had broken through the
skin. The other girl had fainted too apparently but she finished the match and then went out to celebrate
with her team mates. I was rushed to Accident and Emergency in the back of our coach’s van.
I was lucky that we had a well-staffed and well-equipped local hospital. (1) _____ The surgeon had to insert
a titanium rod through the middle of the broken bone. This was then fixed near the knee and ankle with
long screws which would eventually be removed. (2) _____ I don’t remember anything of course, but the
surgeon said he had broken several screwdrivers in the process. I think he was trying to be funny – ha-ha!
Recovery was a long process and I won’t bore you with the details. Eventually the doctor told me that I
was ready to start physiotherapy and my first question was about when I could start playing football
again. The physio said that I should speak to my doctor. He started by saying that I had already been
lucky. (3) _____
My doctor told me that contact sports like football were too much of a risk to take. Although the bone had
grown back around the rod and the screws could be removed, the bone was still fragile and could shatter
if I had a similar footballing accident. I knew I had to change my plans and as I pushed myself through
physical therapy that summer, I surprised both myself and my therapist by developing appreciation and
respect for non-competitive activities. I began to explore some of the yoga and Pilates techniques we had
been using in our sessions. (4) _____. In 2012, I signed up for a fun run in my local park. In 2014, I
completed my first half marathon and have gradually worked up to full marathons. I have become a
triathlete and am now in training for my first Ironman competition in New Zealand. My body has changed
but I think the real transformation has been psychological. I don’t take anything life has to offer for
granted and I now know what it means to set a goal and work towards it.
Don’t get me wrong. (5) _____ Different things bring it on. I managed to set off an alarm in an airport last
summer. When it is damp, my leg aches – I can even predict some changes in the weather. And of course,
every time I get changed for sport or the beach I see the scars. The healing process was a long one and I
wouldn’t wish that on anybody. But I can’t help thinking that I wouldn’t be the person I am today if we
hadn’t both gone for that ball. So, what would I do if I met that defender again? I don’t think I could ever
really thank her for breaking my leg but maybe I’d ask her if she wanted to come for a run…if she
remembered who I was of course.

O. I was to learn later than I had suffered a compound fracture of my tibia

A. The goal was for the bone to gradually grow back together around the rod.

B. I also realised that I could enjoy running without a ball but still wanted to compete.

C. It was decided that I should have emergency surgery there and then.

D. Some tibia breaks like mine have ended up with a lower leg amputation.

E. Many other athletes with similar injuries can return to their sport within a year.
F. Hardly a day that goes by that I don’t think about that defender and the fifty-fifty ball.

QUICK CHATS
Take it in turns to ask and answer the questions about the photos
• What’s happening in the picture?
• What happened just before?
• What will happen next?
• Have you ever been in a situation like this?

WATCH

Sports Injuries?
https://www.youtube.com/watch?v=30ax40myDWw

Some of this video is quite shocking. If you don’t want to watch it, tell your teacher.
As you watch, complete the table. When you finish, compare notes with a partner.

Talk about when you were younger.
Write a couple of things you can talk about in each circle.
Work with a partner or in small groups. Exchange your information.

VOCABULARY

Bone Breaks and Types of Fracture

Match the following fractures with their definitions below A-H.

1 Greenstick Fracture 5 Non-displaced Fracture

2 Hairline Fracture 6 Displaced Fracture

3 Segmental Fracture 7 Open or Compound Fracture

4 Buckle Fracture 8 Closed Fracture

A. A fracture in a young bone where the bone is bent and fractured on the outside only.
B. A fracture where the bone is protruding through the skin.
 C. A fracture where bones are compressed and crush in on themselves
D. A fracture where the skin is unbroken around the injury.
E. A fracture where the ends of a broken bone have been pushed out of alignment.
F. A fracture where the bone is broken but the broken ends are still aligned properly.
G. A fracture in two or more places in the same bone.
H. A fracture where the bone isn’t broken but has a very thin crack in its surface.

WRITING

A formal email
You work as a physiotherapist in Glasgow but have just injured yourself while skiing on holiday.
You will not be able to return to work on Monday, so you decide to send an email to your boss.
In your email you should:
• Describe your accident.
• Explain the injury and any treatment you have received.
• Apologise and inform your boss when you think you will be returning to work

Write your answer in an appropriate style in 160-200 words.

You might find some of this language useful:



VOCABULARY

Body Parts Crossword

Across Down

1 Where your femur meets the tibia (4)
2 We have one, a cow has three (7)
6 The first part of the small intestine (7)
8 The arm’s hinge joint (5)
10 It can be curly or straight (4)
11 Heart chambers (5)
12 Smoking damages these (5)
15 These carry blood to the heart (5)
17 It can be found in a 7 down (3)
18 This organ pumps blood (5)
21 Electricity excites this cell (6)
22 It could be the thyroid (5)
24 A macronutrient (3)
25 Integumentary material (4)
26 This responds to sensory stimuli (8)
27 A cauliflower for hearing? (3)
1 This organ cleans your blood (5)
3 ‘Finger’ with two phalanges (5)
4 The main human artery (5)
5 A funny bone? (7)
7 For eyes or planets (5)
9 Joins your hand to your arm (5)
12 Only vertebrates have this filter (5)
13 Protection for toe or finger (4)
14 Your cheekbone (5)
16 This protects your brain (5)
18 It’s prehensile (4)
19 Goes from head to heart (7)
20 Finger joint (7)
23 This conducts signals in the body (5)
24 They have arches (4)

WATCH & LISTEN

Focus on Osteoporosis
Before you listen discuss what you know about osteoporosis with a partner
Watch and listen to a presentation about osteoporosis. Note down answers to the questions below. Listen
to the recording again to check your answers.
Osteoporosis – Nucleus Health (https://www.youtube.com/watch?v=eYGkT6OrBk0)
1. What do osteoblasts and osteoclasts do?

2. What does the physiotherapist means by “bone is not static”?

3. What imbalance between bone formation and bone loss does osteoporosis produce?

4. What adjectives can you use to describe osteoporotic bone?

5. In what bones do osteoporotic fractures usually occur?

6. What sign of advanced osteoporosis is shown in the picture?

7. What is the general term for physical activities that stimulate bone growth?

8. What activities in particular can stimulate bone growth?

Now listen to the following talk by a doctor on the role of exercise in preventing osteoporosis.
http://www.webmd.com/osteoporosis/video/exercise-osteoporosis

Decide whether the following statements are true or false, based on what you understand.

QUICK CHAT
Work in pairs or small groups. Try to design an exercise programme for a woman of 70 with osteoporosis
who has not broken any bones. Pay careful attention to the activities you select.
.
 joints and movement

SPEAKING

Discuss these questions with a partner.

• Most human joints are synovial joints. What does this mean?
• How many are there?
• Can you think of any joints which are not synovial?
• How many of your joints can you touch and name now?

Now watch ‘The Six Types of Joints – Human Anatomy for Artists’
(https://www.youtube.com/watch?v=0cYal_hitz4)

VOCABULARY & READING

Try this quiz on your phones – ‘Sporcle Human Joints’ (https://www.sporcle.com/games/Gmarg/names-of-

joints)

Five phrases have been removed from the text. Choose from A-F the one which best fits each gap 1-5.
There is one extra phrase you do not need to use.
A. based on the way they move
B. It allows rotation
C. One of the criteria used
D. at the base of the thumb
E. an example of fixed joints
F. feels difficult to move

A joint, also known as an articulation, is the point where two or more bones are joined. For example, the
knee connects the femur and the tibia.
(1) to classify joints is their mobility or range of motion (ROM). It is the range, measured in degrees,
through which the joint can be extended and flexed. According to this criterion, joints can be divided into
3 categories: immovable (no ROM), slightly moveable (limited ROM) and freely moveable (full ROM).
The sutures between the bones of the skull are (2), also known as synarthroses. The joints at both ends of
the clavicle or the sacro-coccygeal joint are slightly moveable and the term for such joints is
amphiarthroses or cartilaginous joints. The knees, elbows, wrists, shoulders and ankles are examples of
joints with full ROM and they are called diarthroses or synovial joints.
Another classification of moveable joints is (3). A ball-and-socket joint, like the hip and the shoulder,
allows the greatest ROM. In health, a person may bend, straighten, move sideways and rotate the hips
and shoulders. A hinge joint, like the elbow or finger joints, allow bending and straightening. The elbow
joint is in fact a compound hinge synovial joint. An ellipsoidal joint, like the one between forearm and
wrist can be fairly freely bent and straightened with only limited rotation. The only saddle joint is situated
(4). We can move the thumb backwards and forwards and from side to side, but rotation is limited.
Gliding joints, like joints in the foot and wrist, allow limited movement. The joint between the first and
second vertebrae is a pivot joint. (5) of the head and its movement from side to side.
Try to answer these questions. Underline any answers you find in the text.
1. What does ROM stand for? What does it describe?
2. What terms can be used to describe the joints between the bones of the skull?
3. What range of motion is possible in the sacro-coccygeal joint?
4. Which joints allow the greatest range of movement?
5. What movement is possible in the hinge joint?
6. Can you extend, flex and rotate the ellipsoidal joint?
7. Where are the saddle joints situated in the body?
8. Which joints do we use when we shake our head?

Describe this picture
• What can you see in the picture?
• How do you think the people are feeling?
• Have you ever done anything like this?
• What do you do to relax?
• Unsplash by Form

QUICK CHAT

Living with Osteoarthritis

What do you already know?

• What is osteoarthritis?
• Which joints does it affect?
• Who does it affect the most?
• What treatments exist to manage osteoarthritis?
• Do you know anyone who has this condition?

Watch the video and complete the sentences with the missing information.
http://www.webmd.com/osteoarthritis/video/living-with-osteoarthritis

1. Another name for osteoarthritis is ____________ arthritis.

2. The joints which are most affected by osteoarthritis are hands, ____________, spine and the most
common is ____________ .
3. The number of people in the USA affected by osteoarthritis is ____________ million.
4. Numbers of people with osteoarthritis are growing among the population due to ________ ____________ .
5. The doctor demonstrates the wearing down of the ____________ in the knee.
6. Osteoarthritis normally affects people aged ____________ .
7. There are 2 kinds of injections which help decrease pain in the knee: hyaluronic acid and ____________ .
8. After knee replacement surgery, you are not allowed to run or ____________ .
9. To make your body more resilient to osteoarthritis you should: control ____________, exercise
____________ a week and strengthen ____________ around the knee.

GRAMMAR FOCUS

THE PRESENT PERFECT
As we have seen, we use the PAST SIMPLE to talk about things which happened in the past. When there
is some kind of relationship between what happened in the past and the present, we often use the
PRESENT PERFECT.
We use the PRESENT PERFECT to talk about things which started in the past and are still true now.
I have lived here since 2012. (SIMPLE FORM)
I have been living here since 2012. (CONTINUOUS FORM)

The construction is easy. For the simple form use ‘have/has + past participle’. For the continuous
form use ‘have/has + been + -ing form’. We usually use the simple form for states and the continuous
form for actions.
We use the PRESENT PERFECT to talk about past experiences when we don’t say when they
happened.
 I have never ridden a horse.
She has been to Brazil three or four times.

We use the PRESENT PERFECT for recent past actions which are important now.

Have you seen Raquel? (I’m looking for her now)

He has broken his leg. (That’s why he can’t play)

We don’t use the continuous form in these cases.

For explanations and practice of the basic forms, you can look here:
https://learnenglish.britishcouncil.org/intermediate-grammar/present-perfect

PRESENT PERFECT PRACTICE

Choose the correct verb options for the conversation which is happening in this interview.

Ms Zetkin: So Mr Steel, have you / did you ever work abroad before?
Mr Steel: Yes, I taught / have taught in Brazil from 2011 until 2017.
Ms Zetkin: And for how long have you been/did you be a language teacher?
Mr Steel: I started / have started when I left university in 2008.
Ms Zetkin: What have you studied / did you study?
Mr Steel: Languages and applied linguistics. I have done / did my work experience in Portugal.
Ms Zetkin: Do you have any post-graduate qualifications?
Mr Steel: I started / have started a distance-learning course in ‘Young Learner Education’ last June but I
didn’t finish / haven’t finished it yet.
Ms Zetkin: And what do you do in your free time?
Mr Steel: I play a lot of tennis. In fact, I have been playing / I play since I was / have been a child.

Preparing for an interview

A local American football team is looking for a physiotherapist to work with their youth teams
next season. The job doesn’t pay much but would be a good way for a new or trainee
physiotherapist to get some experience.

1. Take some time to prepare the interview with a partner.

2. Role-play the interview.
3. Change roles and do the interview again.

READING

Read this interview with Joe Mellor, a physiotherapist who works with professional athletes in
London. He thinks prevention is better than cure when it comes to our joints. We ask him for
some advice here.
Thanks for taking the time to talk to us Joe. Running is really fashionable nowadays but is it good for our joints?
Well, running is a great fitness tool but you do have to be careful. Too much impact puts stress on your joints and
this can lead to problems if you’re not well prepared and equipped. You should try to mix in low impact exercises
with your running programme. This will help build the muscles which support and protect our knees, hips and
ankles. You shouldn’t underestimate the positive effects of swimming, elliptical machines and even treadmill
walking when it comes to strengthening muscle. You can also burn fat while preparing your joints for greater
impact.
How important is stretching?
It’s important to maintain a good range of motion around your joints and stretching helps here – both dynamic
and static exercises are beneficial. If your muscles are stiff, you can’t exercise properly. Stiff joints can also
result in swelling after exercises and this can weaken the muscles which are there to protect your joints. You
should warm up all the main muscle groups before exercise and don’t forget to stretch afterwards. Warming
down is important too.
What about diet – is what we eat important?
If you want to have healthy muscles and joints, it’s a good idea to keep excess body fat to a minimum. We also
know that more alkaline diets help keep energy levels up and inflammation down. Apart from that you should
remember to follow typical dietary advice for a healthy life – I don’t need to repeat it here, but if you avoid junk
food and fizzy drinks and opt for fresh foods with lots of fruit and veggies, you’re more likely to want to exercise.
I don’t really like the word ‘diet’ – I think it’s more about a lifestyle choice.
Is it worth spending a lot of money on equipment?
It’s important to choose your running shoes carefully – it’s not a fashion choice. They need to offer stability and
cushioning as well as comfort. They need to fit the shape of your feet – our arches are different and you need to
take this into account when choosing. Crucially for runners, you need to think about the elastic compression
ability of the shoes. Depending on how you run and how much you weigh, this starts decreasing after about 400
kilometres or six months of use. Not replacing shoes is a false health economy – it’s dangerous to put too much
stress on weight-bearing joints.
And if we spend a lot of time sitting at work?
Sitting is a big health risk, especially if your posture is bad. This can tighten and inhibit your muscles. It can also
hurt. When your body isn’t moving, it’s difficult for the discs in your spine to get the blood supply they need. So,
if you have to sit a lot, get up, stretch and move around at least once an hour. Make sure your seat provides
support for your lower back – a rolled up towel or thin pillow will do the trick. Your computer screen should be at
eye level, your wrists supported and try to keep your feet flat on the ground.
Is stress dangerous for our joints?
Absolutely – if we are suffering from stress, we can produce too much of the stress hormone cortisol. Too much
cortisol reduces the amount of collagen our bodies produces and we need this for healthy joints. So, yes – we
need to keep our stress levels low. Diaphragmatic breathing is known to bring down stress hormone levels. It
might be worth trying yoga or other relaxation techniques if things are getting on top of you.
So we need to know when to stop?
Exactly – knowing when to stop can mean the difference between improvement and injury. Pain is a message and
the message is ‘That’s enough!’ If pain persists after exercise, then it’s time to visit a health professional. The
idea of ‘no pain, no gain’ is an old fashioned one. There’s no reason you can’t be fit, healthy and happy without
having to suffer.

Now choose the best answers from these multiple-choice questions about the interview.

1. Considering joint health, running …
a) is good for making joints strong.
b) needs to be complemented with other exercises.
c) is not as good for you as walking.
2. Stretching …
a) stops joints from becoming rigid.
b) can make swelling worse.
c) should be done before doing sport.
3. To control inflammation, you should …
a) eat lots of fruit.
b) control your body weight.
c) eat a non-acidic diet.
4. Running shoes …
a) are good for any activity.
b) need to be changed once or twice a year.
c) are bad for joints.
5. You can reduce the negative effects of sitting by …
a) leaving your desk at regular intervals.
b) getting a better chair.
c) improving your blood supply.
6. Stress hormones are controlled by …
 a) collagen.
b) respiration exercises.
c) developing flexibility
7. Your body will tell you when you …
a) are pushing it too hard.
b) need to see a doctor.
c) have an injury.

WATCH

Watch this video about posture and try to answer these questions with short notes.
https://www.youtube.com/watch?v=OyK0oE5rwFY


WRITING – AN ARTICLE

You see this announcement in an online health and fitness magazine.

Write your answer in 120-180 words in an appropriate style.
For an article you should remember to:
• Write a clear title. You can use the one given in the question if it is appropriate.
• Try to start in a catchy way. Why not use a general statement followed up with a rhetorical question?
• Make sure the three main paragraphs are balanced.
• You should always leave the reader with something to think about in the conclusion. A suggestion is
often appropriate: ‘So, next time you...’
• When you finish ask yourself these questions:
✔ Have I answered the question?
✔ Are my paragraphs clear and balanced?
✔ Is the formality ok?
✔ Is my spelling OK?
✔ Have I checked the grammar for tenses and agreement?
✔ Have I made any of those typical mistakes my teacher always mentions?
✔ Am I happy with it?

Have a look at these sentences. They contain common verbs which are useful for physiotherapists. These
verbs are in bold.
1. Several players had to be treated for cuts and bruises after the match.
2. The massage should soothe the pain in her leg muscles.
3. We’re not sure if this conditioned can be cured with traditional methods.
4. I’d like to specialise in neurological physiotherapy when I qualify.
5. The doctor prescribed a course of anti-inflammatories.
6. The physiotherapist diagnosed a stress fracture in the lower limb.
7. The drugs may reduce but not suppress the pain.
8. He suffers from chronic back pain.
9. Unfortunately, the patient does not comply with the treatment.
10. The patient may have to undergo surgery.
11. Student physiotherapists are expected to attend all of their lectures.
12. The patient was referred to me by her GP.
13. Several of the new prosthetic limbs have been rejected in early stages.
14. The cream should be applied every morning.
15. The players bruised their heads in the collision.

Now match the verbs with their definitions. Use the infinitive. One example has been given.
Suppress means to reduce the action or impact of something completely.
_________ means to identify and name a medical problem.
_________ means to experience something traumatic or unpleasant.
_________ means to say what medical treatment somebody should have.
_________ means to entrate on one particular subject or area.
_________ means to use drugs and exercises to attempt to cure someone.
_________ means to send someone to a specialist for help.
_________ means to make someone healthy again.
_________ means to spread or rub into the skin.
_________ means to calm or make less painful.
_________ means to be present.
_________ means to follow a recommended course of treatment.
_________ means to have a negative physical reaction.
_________ means to damage by hitting and change colour.
_________ means to experience physical or mental pain.
.
 muscles and health

WATCH

Before you watch a short video about our muscular system, discuss these questions with a
partner.
• What are our muscles and what do they do?
• How many muscles does an average human have?
• Have you ever injured a muscle?
Now watch ‘The Muscular System Explained in Six Minutes’ and complete this chart.
https://www.youtube.com/watch?v=rMcg9YzNSEs

Answer the questions in note form

What is the main function of the muscular system?

What are the five major properties of the muscular system?

Describe five typical muscular movements.

What three types of muscles make up the system?

What are the two main supportive structures?

READING

Warming Up and Cooling Down

Warming up prepares your body for physical activity and reduces the chances of injuring your muscles, which
are at more risk when they are cold. Cooling down is important as it helps the body clear lactic acids that build
up during sports activities. If you get rid of the lactic acid you’ll feel less stiff and sore the day after your
exercise. So, try to incorporate warming up and cooling down activities into your training and match day
routines.

WARM…
Of course it depends on your age, level and the sport itself but a good warm-up should involve the muscle groups
and activities that are needed when practising or performing. You should start at a low level of intensity and
gradually build up to meet your training or competition needs. Pre-training warm ups may only last for 5 or
10 minutes but this should definitely be increased when the weather gets chillier.
Warm-up objectives are:
• Preparing your mind and body for physical activity.
• Raising your body’s core temperature.
• Raising your heart rate.
• Increasing your breathing rate.

COOL…
It’s easy to forget cool-down activities after a training session or competition. After intensive physical
performance, slowing the body down takes time and is central to injury-free recovery. The cool-down only needs
to last 5 or 10 minutes but must happen immediately after training activities. It can involve the same type of
activities as the warm-up but with a lower-intensity; for example, jogging or walking can replace running.
Stretching after physical exertion helps with maintaining and building flexibility, relaxing the muscles and
returns them to their natural resting length.

STRETCH…
Nowadays, static stretching at the warm-up stage is not as popular as it used to be. Muscle groups should be
prepared for the full range of movement they are going to be asked to perform – this is active stretching. As we
have seen, static stretching is still useful at the cooling down stage and helps with flexibility. Stretching sounds
simple but there are some guidelines you should follow:
• Always warm up before you stretch.
• Stretch pre- and post-exercise. Active stretching for warming up and static stretching for cooling down.
• Remember to stretch all muscle groups that are going to be used.
• Work gently and slowly – don’t jerk or force things.
• You should feel the effort but it shouldn’t hurt.
• Breathe slowly and easily. Holding your breath is a bad idea.
• Do not turn stretching into a competition! That comes later.
Now answer these multiple-choice questions about the text.
1. Warm-up and cool-down activities should…
a) replace training and competition routines.
b) be compulsory parts of training routines.
c) be added to existing routines.
d) be competitive.

2. In cold weather warm-up sessions should…

a) be longer.
b) last for between 5 and 10 minutes.
c) be intense.
d) be shorter.
3. The objectives of warming up are…
a) unclear.
b) physical.
c) psychological.
d) both psychological and physical.

4. When should cooling down take place?

a) 5 or 10 minutes after training activities.
b) Only after vigorous exercise.
c) As soon as training finishes.
d) After stretching.
5. Cool-down exercises …
a) are the opposite of warm-up exercises.
b) are identical to warm-up exercises.
c) are less intense than warm-up exercises.
d) are more relaxing than warm-up exercises.
6. Static stretching...
a) is useful after exercise.
b) is no longer used.
c) is a central warm-up activity.
d) is unpopular.

7. When stretching it is important...

a) to breathe deeply.
b) not to breathe.
c) to breathe in a relaxed way.
d) to breathe in time with your movements.
8. What is the main purpose of this text?
a) To warn people about the dangers of stretching.
b) To encourage people to do exercise.
c) To give people information about warming up and cooling down.
d) To explain the difference between warming up and cooling down.



WRITING – A REPORT

Your university recently organized a team of volunteer physiotherapists at a sports event in

your town.
Now your tutor has asked you to write a report about the event.

In your report you should:
• Describe the event.
• Explain why a team of physiotherapists was needed.
• Suggest some changes you might make for future events.
Write your report. You should use between 130 and 160 words.
Remember that for a report you need clear headings and a short introduction. You might find some of the
following expressions useful:
• To express personal opinions: In my opinion, I believe (that) / I feel (that) / it seems to me / in my view /as I see it / I think /
personally

• To show purpose: to / in order to / so as to / so that

• To list ideas: Firstly / secondly / finally / In the first place / Lastly
• To contrast ideas: However / although / in contrast / whereas / but / nevertheless / in spite of / despite
• To describe a cause: Because / since / as / due to
• To show a sequence: First of all / then / after that / eventually / in the end / finally
• To add information: In addition / moreover / what is more / besides / too / furthermore / and
• To describe a consequence: Consequently / as a result / therefore / so / thus / for this reason / that is why
• To conclude the topic: In conclusion / to sum up / in short / all in all

And when you finish remember to check:

✔ Have I answered the question?

✔ Is the formality ok?
✔ Is my spelling ok?
 ✔ Have I checked the grammar for tenses and agreement?
✔ Have I made any of those mistakes my teacher always mentions?
✔ Have I used some suitable linking expressions?
✔ Am I happy with it?

LISTENING & QUICK CHAT

Park Running in the UK

• How much exercise do you do in a typical week?
• Do you ever go running?
• If so, where do you run and who do you run with?
• What can you see in the picture?
• Are there events like this where you come from?

You will hear part of a radio programme about parkrunning. http://www.bbc.co.uk/programmes/p05xb0rx
Read the introduction then complete the sentences below.
Every weekend over 1.5 million people run 5,000m on Saturday mornings for parkrun, which is a free
event that takes place all over the UK and across the globe. Each runner is given a bar code, which is
scanned at the end of the run and fed into a database showing them what place they came in their race.
Jordan Dunbar and Tim Hartford take a look at which courses are the fastest, slowest, hardest and
easiest.
Jordan’s local parkrun takes place in 1
At the Hackney Marshes parkrun Jordan got stuck 2
His time was 3
People in Hackney are described as _____ and _____4
The average age grade for Hackney is 5
The easiest course is in 6
The hardest course is in 7
The man first ran the race he reviewed 8

Discussion Theme – Public Spaces

• What public parks and spaces are there near where you live?
• Are these spaces used for health and fitness activities?
• Do you prefer exercising indoors or outdoors?

GROUP SPEAKING ACTIVITY

How healthy are you?

Work in small groups to prepare five questions about your classmates’ lifestyle.
Now interview five classmates who you don’t usually work with. Take notes of the answers.

Q1 - ___________________________________________________?

Q2 - ___________________________________________________?

Q3 - ___________________________________________________?

Q4 - ___________________________________________________?
Q5 - ___________________________________________________?


GRAMMAR FOCUS
FUTURE TIME
Like in most languages, there are different ways of expressing future time in English. There is no single
future tense in English, so the language we choose depends on the situation and on what we’re trying
to express.
We often use the PRESENT SIMPLE to talk about future events / actions which are timetabled and
that we cannot change.
The film starts at seven o’clock. When does your train leave?
For future plans and arrangements we can use GOING TO or the PRESENT CONTINUOUS. These are
very similar.
I’m going to play tennis tomorrow. I’m playing tennis tomorrow.
For predictions we can use either GOING TO or WILL. When something in the present gives us clues
about the future, we use GOING TO.
She’s driving too fast – she’s going to crash.
Look at those clouds – it’s going to rain.
For more general or hypothetical predictions, we use WILL.
Maybe I’ll go for a walk later.
You’ll love Prague – it’s beautiful.
For instant decisions, promises, offers and suggestions we use WILL or SHALL.
I’ll give you a lift if you’ve missed the bus.
I won’t tell anyone – I know it’s a secret.
It’s really hot – shall I open a window.
Shall we go to the cinema tonight?
For more information and practice of these future forms, you can look here:
https://learnenglish.britishcouncil.org/english-grammar/talking-about-future

Choose what you think is the best future form to complete these sentences. Sometimes there is more than
one possible answer.
1. I _____ (see) my physio tomorrow morning at ten.
 2. They are playing very well. They ____ (win) the league.
3. Do you need anything? I _____ (go) to the shops.
4. When I qualify I _____ (specialise) in sports physio.
5. Don’t worry – I _____ (tell) her about the results.
6. The match _____ (start) at eight. Don’t be late.
7. I _____ (study) abroad for a couple of years.
8. Where do you think you _____ (be) in ten years?
9. I’ve decided that I _____ (look for) a new job.
10. He _____ (open) a new clinic in Boston.

Discussion Theme – Your future

• What study or professional plans do you have for the future?
• What changes do you anticipate in the world of physiotherapy?
• Are you generally optimistic or pessimistic about the future?

Now just watch this talk about how technology is being used to help people with missing limbs.
https://www.ted.com/talks/hugh_herr_the_new_bionics_that_let_us_run_climb_and_dance?language=en


READING

Read the following magazine article about Tina Weybone’s job an alternative health therapist. Put the
phrases (A-G) in the right place. There is ONE EXTRA PHRASE that you should NOT use. Write your
answers in the spaces in the text. An example (0) is given.

This month in HORIZONS we feature Tina Weybone, who works with a variety of
alternative therapies.
I was a teenager living in China with my parents when I first experienced acupuncture. It wasn’t regarded
as alternative and was commonly used not just to cure not but also to stay balanced and prevent illness. I
think this time spent away from Europe had a great impact on the way I feel about medicine and life in
general. For me, the two go hand in hand.
For this reason complementary treatments are central to my practice for me because I am convinced that
they focus on more than the physical aspects of a problem. (1) ______. This medicine has produced some
great results but it is often very traumatic for our bodies. Alternative therapies like acupuncture and yoga
tend to be more gentle and produce fewer side effects. When a person’s ill, we look at them as a whole
and try to work with the different energies which may cause and of course cure the problem. Usually this
is a question of retuning or rebalancing a person’s energy flows. In acupuncture this involves looking at
the energy flowing in the different meridians of a person’s body. (2) ______ Different practitioners regard
these in various ways but the common theme idea is to keep them free and flowing in order to regain or
maintain good health.
Like most therapists working in these areas, I practise what I preach and try not to rely on Western
medicine. (3) ______ This helped me both emotionally and did a lot to help me get over the physical
manifestations of my problems too. I feel very deeply that it is a mistake to separate the physical from the
mental, or the body from the mind, to put it another way.
I’ve dealt with all sorts of patients with all sorts of problems. Increasingly, and especially since I’ve moved
back to the city, many problems are stress related (4) ______ One woman I deal with developed serious
joint pain after changing jobs. We have reduced this using relaxation techniques.
Some people think that those of us who work in the area of alternative and complementary therapies
study less than our more orthodox counterparts. This just isn’t true. My course in chiropractic lasted
three years like a normal degree. (5) ______ I had to write a long final project and had two one-month
placements. Unfortunately, this degree isn’t recognised as widely as more traditional qualifications.
My aim is to carry on working in this field. Helping people feel better is so rewarding. I think I’d like to
work with other professionals who have a similar approach. (6) ______ We could also rely on each other
for alternative insights and support. There are a lot of people suffering out there and I think it’s important
for them to have as many healing options as possible made available to them.

A. These are like streams of energy which travel throughout our bodies on established courses

B. We forget how daily tensions can have physical effects

C. Sometimes it’s a bit lonely on your own

D. I had to put my life on hold while I was studying

E. It isn’t true that these methods are more expensive

F. I have recently finished a course of reiki to help me get over a problem

G. This belief in the importance of the mind or spirit is very different from Western medicine


TIME FOR A CHAT

Discuss these questions in small groups.

1. Do you think there is a difference between alternative and complementary therapies?
2. If you had a serious illness or injury, would you go to an alternative therapies practitioner?
3. Do you think you need to believe in complementary therapies for them to work?
4. What types of injuries or illnesses can these therapies help?
5. In some countries, the government has begun integrating complementary therapies and alternative
medicine into the National Health System. Do you think alternative therapies should be paid for by the
health system?

What do you know about cryotherapy?

Watch the video and decide if these sentences are true or false.
https://www.youtube.com/watch?v=qYZ-PEXNJN0


Watch this short video about homeopathy.
https://www.youtube.com/watch?v=8HslUzw35mc

With a partner discuss:

• what you remember from the video.
• whether you agree with it.
• if you have or would ever use homeopathic treatments.

VOCABULARY

Eights For Physio – Complete the lists with a partner.

.
 career choices in physiotherapy

WATCH

Discuss these questions with a partner.

• What are the main branches of physiotherapy?
• In which field do you think you would like to specialise?
• What would you say were the advantages and disadvantages of working in your chosen area?
• Now discuss the meanings of these words:
responsibility rotations shadowing work-experience careers advice
voluntary self-employed abroad team work skills
qualifications shifts salary job security commitment

Megan Forsdyke de Almeida is a neurological physiotherapist. Listen to her taking about her
work and make notes to answer these questions.
https://www.youtube.com/watch?v=JmsiTVozm9k

Now listen to Neal Reynolds talking about becoming a sports physio.
https://www.youtube.com/watch?v=taXSXxYHX9c

Listen again and choose the best answers to these questions.

1. What is the first thing you should do if you want to become a sports physiotherapist?
a) Choose the sport you like the most and study the clubs where it is played.
b) Be certain you want to be a physiotherapist.
c) Get a physiotherapy degree with a sports specialisation.
2. What should you do when you finish your degree?
a) Get experience of different kinds of physiotherapy.
 b) Get a job with a sports club.
c) Focus on doing only sports physiotherapy.
3. What is the next thing you should do?
a) Do some volunteer work for a club and then do further training.
b) Become a first-aid specialist with a local team.
c) Get a job with a small, local club and get experience.
4. What are the disadvantages of being a sports physiotherapist?
a) You work 10 to 11 hours a day and you have to travel a lot.
b) You have to give the job a lot of time and dedication.
c) You work almost every day of the week with very few holidays or breaks.
5. Why is it difficult to get initial training with sports clubs, even as a volunteer?
a) Their physiotherapists are too busy.
b) Too many people apply for this type of work.
c) In the past they have taken on volunteers with too little knowledge.

QUICK CHAT
• What’s going on in this picture?
• How could a physiotherapist help these athletes?
• Have you ever been in a situation like this?

Working with Kids

Four Top Physios tell us about the challenges of working with younger patients.

Monika
As paediatric physiotherapists, we have a lot to manage. We can work in very different environments –
hospitals, homes, schools and community centres and we deal with a wide range of conditions. In one
day I can see children who have respiratory, musculoskeletal or neurological problems. So, we have to
be able to move from one speciality to another in a short time.
Developments in research have an impact on our practice and we have to keep up with innovations. For
example, in the case of cerebral palsy, we seem to be moving away from focusing on inhibiting
 abnormal activity. We now aim to strengthen affected muscle groups – this is producing positive results
but we have to monitor these carefully.
It’s hard to think of a job which combines theory and practice so closely. Keeping up to date with what
is going on can take a lot of time and energy but it pays dividends in terms of results and satisfaction.

Kojo
Our Children’s Physiotherapy Service offers a child and family centred approach to children and young
people (CYP) from 0-18 years who have a physical disability or condition that impacts on their
development and their functional daily activities at home or in school.
The Physiotherapy Service will provide assessment, treatment, rehabilitation, education and advice for
CYP with physical difficulties. The service works with families, nurseries, schools and other health and
social care professionals. We recognise the importance of working in partnership with the child,
parents and carers to maximise a child’s physical abilities and independence.
Childrens’ Physiotherapists aim to develop both gross and fine motor skills e.g. walking and object
manipulation. Physiotherapy can be advice or a hands-on approach that ensures the child is optimally
positioned to carry out activities and exercises.

Aisha
Play activities are absolutely central to my work. Without these I don’t think many of the children I see
would regain the skills they have lost through illness or injury.
We try to introduce fun elements wherever we can. So, arm exercises can involve ball games and the
mega-drawings you can see on the walls here. The obstacle course over there is a favourite and the kids
often forget that they are in fact retraining specific movements as they play. Another favourite is
singing action songs.
There are endless possibilities for the inventive physio who understands the importance of not letting
younger patients become bored. For too long we treated children as mini-adults. They have specific
physical needs and we try to meet these in ways which work for them. The therapist needs to have a
selection of activities to choose from and be ready to change if something doesn’t work out.

Guang
Good practice with children means following a certain number of key professional guidelines.
Increasingly this means an approach which focuses on the patient as a whole person and not just the
specific condition they may have.
The child has to be placed at the centre when treatment is planned but the impact the patient’s
condition may have on the rest of the family has to be remembered at all times. It is essential that
young patients and their families feel that they are active participants in the decision-making process
regarding the treatment of their condition.
This requires a new skill set from PTs. They need to facilitate and negotiate treatment programmes
rather than prescribe them. In this way they should develop services in line with government guidance
committed to improving quality and life chances for children.

Which physiotherapist (M, A, K or G) mentions…

1. a more holistic approach to patients?

2. the importance of working with other agencies?
3. the benefits of being aware of research?
4. using art as a physiotherapy technique?
5. the benefits of a new approach?
6. the importance of maintaining motivation?
7. official advice concerning professional practice?
8. not making assumptions about results?
9. the specific age groups they work with?
10. The wider impact of a patient’s condition?



WATCH

Watch this video about ‘Kids Physiotherapy’ in Vancouver

(https://www.youtube.com/watch?v=zh0B28QnuQo)

Try to complete these sentences.

1. Laura has been a physiotherapist for

2. She started ‘Kids Physiotherapy’ ago.
3. She wanted to between the public and private sectors.
4. ‘Kids Physiotherapy’ offers physiotherapy for kids.
5. Children like coming to ‘Kids Physiotherapy’ because it is very .
6. The little girl really likes .
7. They recently had a day. (two words)
8. Laura says she is looking forward to .

GRAMMAR FOCUS
FIRST AND SECOND CONDITIONALS
When we are talking about things which happened in the past, we usually use what are often described
as the narrative tenses.
We use the FIRST CONDITIONAL to talk about future actions and the consequences of these actions.
We usually use IF + PRESENT SIMPLE, WILL/WON’T + INFINITIVE (the order is not important)
If she follows the treatment, she will recover quickly.
He won’t pass the exam if he doesn’t study harder.
We use the FIRST CONDITIONAL when we are quite sure about something. If we are less sure, or if
we are making a hypothetical statement, we use the SECOND CONDITIONAL.
We usually use IF + PAST SIMPLE, WOULD + INFINITIVE
If she took the medicine, she would feel better.
If I had more time, I would play more tennis.

A few points to remember…

• This is a little subjective but the conditional we use depends on how likely we think something is
going to happen.
 • We can use ‘unless’ instead of ‘if…not’ in conditional sentences.
• It is common to use ‘If I were …,’ in second conditional sentences for advice and unreal
statements.
e.g. ‘If I were you, I’d go to a doctor.’ ‘If I were rich, I’d move to Brazil.’
For further explanation and practice of this, have a look at:
https://learnenglish.britishcouncil.org/intermediate-grammar/conditionals-1

Complete the second sentences so they have the same meaning as the first.

1. I think I’ll pass my exams, and then it will be easy to get a job.
It easy to get a job if I my exams.
2. She doesn’t have enough money, so she can’t open her own clinic.
If she enough money, she her own clinic.
3. Doing the work experience will improve your CV.
Your CV , if you the work experience.
4. He can’t do the job in Japan because he doesn’t speak Japanese.
If he Japanese, he the job in Japan.
5. You need to do well in the interview to get the job.
You the job if in the interview.
6. They aren’t qualified and that’s why we can’t employ them.
If they , we them.
7. He isn’t going to get better because he isn’t doing the exercises.
If he the exercises, he better.
8. The results should be positive. Then we’ll send her home.
If the results of the X-ray positive, we her home.
9. He needs to train more often – then he’ll be selected.
He selected unless he more often.
10. I think you should try to get more sleep – you look tired!
You look tired - if I , I to get more sleep.

FOCUS ON WRITING – APPLICATIONS



Choose the best options from (1)-(10)

• What do you think of Rene’s letter?

• Which expressions would you use in a similar letter or email?

Now it’s your turn.

You would like some practical work experience. You see this advertisement for a summer
placement and decide to apply.
• Is this going to be a formal or informal email?
• How are you going to start and finish?
• Refer back to the language and style tips we saw earlier.
In your email you should:
• Explain why you are interested in the placement.
• Describe any relevant experience you have.
• Outline the skills and qualities you can bring to the job.
Write your email. You should use between 130 and 180 words.
And when you finish remember to check:

✔ Have I answered the question?

✔ Is the formality ok?
✔ Is my spelling ok?
✔ Have I checked the grammar for tenses and agreement?
✔ Have I made any of those mistakes my teacher always mentions?
✔ Have I used some suitable linking expressions?
✔ Am I happy with it?

SPEAKING

QUICK CHAT – WORK

• Is unemployment a big problem where you live?
• Would you move to another country to find work?
• Should the government or private companies be responsible for creating jobs?

What five questions do you think this recruitment agency should ask?

Q1 - ___________________________________________________?

Q2 - ___________________________________________________?
Q3 - ___________________________________________________?

Q4 - ___________________________________________________?

Q5 - ___________________________________________________?

Give each candidate a mark out of 5 for each of their answers.







ENGLISH FOR
PHYSIOTHERAPY
ISBN libro impreso: 978-84-18005-03-9
ISBN libro electrónico: 978-84-18005-21-3
marzo de 2020
 INDEX



ENGLISH FOR PHYSIOTHERAPY

INTRODUCTIONS

THE HUMAN SKELETON

JOINTS AND MOVEMENT

MUSCLES AND HEALTH

CAREER CHOICES IN PHYSIOTHERAPY