Episode 87 - Sinikka Kilpikoski, part 2 - Go As Far As Possible


Dr. Sinikka Kilpikoski graduated as a Physiotherapist in 1969 in the City of Tampere, Finland.  She first specialized in Physiotherapy in Public Health and Geriatrics in 1986 in the Applied University of Jyväskylä graduating with a Masters of Health Sciences in 1994.  In 1988 she began studies in New Zealand obtaining the designation of credential and then diploma.  She began instructing MDT courses in Finland in 1995 and is senior and international instructor for the McKenzie institute.  She has been in private practice for nearly 40 years.  She is a published author and has intention to produce further studies.  


Show Notes



Sinikka shares her opinions about the root of struggles which include functional findings which she says are minimally considered and instead the image findings dominate the reason for clinical decisions.  Large private practices also contribute challenges to Sinikka and a small practice like what she runs.


Memorable Patient Experience

Dr. Kilpikoski shares a patient she calls “Bob the builder” who laid brick building fireplaces.  Bob came in spite of being told that he had a horrible looking xray and needed surgery.  She learned from Bob simply because of his precision of doing his home exercises and even building some equipment to assist him with his exercise.  Since then Sinikka has benefited from Bob coming to see her in additional ways that have helped her practice over the years since first seeing him.


Patient Education Analogy

Sinikka teaches “Pain On, Pain Off” related to posture correction.  She also uses the illustration of a DVD deck opening and closing to explain a common exercise technique. 


Best Advice

Sinikka remembers advice from her brother that she gained upon telling him she was considering leaving physiotherapy and going into medicine.  She took his advice to stay in her profession and go as far as possible.  She did just that, specializing and obtaining advanced degrees and eventually teaching.  


Doing Differently Now

She certainly sees a great difference in how patients were treated 30 years ago where treatment was so passive and seemingly just to fill time.  Now she shares how she’s developed even more recently including spending more time discussing and problem solving together.  Sinikka finds that sometimes she doesn’t use her hands at all because the education and patient movement is adequate.


Impactful Scientific Paper

The reduction of chronic nonspecific low back pain through the control of early morning lumbar flexion. A randomized controlled trial. Snook SH. Spine (Phila Pa 1976). 1998 Dec 1;23(23):2601-7. 

Efficacy of exercise intervention as determined by the McKenzie System of Mechanical Diagnosis and Therapy for knee osteoarthritis: a randomized controlled trial. Rosedale R et. al. J Orthop Sports Phys Ther. 2014 Mar;44(3):173-81, A1-6. doi: 10.2519/jospt.2014.4791.

Transforaminal epidural steroid injections followed by mechanical diagnosis and therapy to prevent surgery for lumbar disc herniation. van Helvoirt et. al. Pain Med. 2014 Jul;15(7):1100-8. doi: 10.1111/pme.12450. Epub 2014 May 7.

Patients' experience of health three years after structured physiotherapy or surgery for lumbar disc herniation. Lïmback Svensson G.  J Rehabil Med. 2013 Mar;45(3):293-9. doi: 10.2340/16501977-1105.


Characteristic Contributing to Success

Sinikka offers that being open minded and to work with her patients as a partner as opposed to an authority and she has the opinion that this attitude enables her to be successful.  She explains further how her clinic provides a good atmosphere for good outcomes for her patients.


Parting Advice

Sinikka offers the keys, as she sees it, for any therapist if they want to be successful.  She explains that listening to patients and study and study and study.