Kinesiologist vs physiotherapist: who to see, and when

The kinesiologist vs physiotherapist question usually comes up after an injury or surgery, or when a doctor says you need to be more active and you’re not sure how to start safely. Both work with movement. The difference is what each is trained, and authorized, to do.

Here’s how their scope and regulation differ in Manitoba, who to see first, what each costs, and what insurance may cover.

What does a kinesiologist do?

Kinesiology is the study of human movement. A kinesiologist has a university degree in kinesiology or a related field and works with exercise and movement: assessing how you move, then building an exercise program around your goals and current ability.

Kinesiology isn’t among the regulated professions listed in Manitoba’s directory of professional regulators, so the title isn’t protected here. Certification, such as CSEP-CEP, is one way to check a kinesiologist’s training for clinical work.

What is a clinical exercise physiologist?

A CSEP Clinical Exercise Physiologist (CSEP-CEP) is certified by the Canadian Society for Exercise Physiology. CEPs perform assessments, prescribe conditioning exercise, and provide exercise supervision, counselling and healthy lifestyle education, for healthy people and for people with musculoskeletal, heart and lung, metabolic, neuromuscular and age-related conditions.

To certify, candidates need an undergraduate degree covering CSEP’s core competencies, at least 100 hours of practical experience, and a pass on both a theory exam and a practical exam, plus current first aid and basic life support. CSEP’s scope of practice is clear that CEPs don’t diagnose conditions. Lindsay Porter, Natura’s clinical exercise physiologist, holds a Bachelor of Kinesiology and the CSEP-CEP certification.

People who see a clinical exercise physiologist include those who are:

• Living with osteoporosis, joint pain or long-standing back pain
• Recovering from surgery or an injury
• Living with a neurological condition
• Going through cancer treatment (see exercise during cancer treatment)
• Returning to activity after an illness or a long break
• Wanting a structured program for strength, balance or mobility

Programs are matched to your current ability and goals, and may start with very gentle movement before progressing over time.

What does a physiotherapist do?

The Canadian Physiotherapy Association describes physiotherapists as professionals who assess, diagnose and treat symptoms of illness, injury or disability. Their tools include personalized exercise programs, massage, joint mobilization and manipulation, and hot and cold packs and other modalities for pain.

Physiotherapy is regulated. In Manitoba, only registrants of the College of Physiotherapists of Manitoba can use the titles physiotherapist or physical therapist, and every registered physiotherapist in Canada has passed a national competency exam.

Kinesiologist vs physiotherapist: side by side

Should I see a kinesiologist or a physiotherapist first?

• Start with a physiotherapist for a new injury, sharp or worsening pain, numbness or weakness, or rehab soon after surgery as your surgeon directs.
• Start with a clinical exercise physiologist if you live with a long-term condition such as osteoporosis and want a structured exercise program, if you’re returning to exercise after illness, or if physiotherapy is finished and you want to keep working on strength.
• See your doctor first if you’ve had chest pain, fainting or unusual breathlessness with activity, or you’ve been told to limit exercise.

Some people see a physiotherapist first for a new injury, then a clinical exercise physiologist once physiotherapy has finished. If you see both, share reports between them so the programs line up.

Is kinesiology covered by insurance in Manitoba?

Manitoba Health covers physiotherapy only when it’s done in a hospital; physiotherapists in private practice aren’t covered. Private kinesiology and exercise physiology aren’t insured services either.

Extended health plans vary, and coverage for kinesiology or exercise physiology depends entirely on your policy, so ask your insurer before booking:

• Does my plan cover a kinesiologist or clinical exercise physiologist, and under what name?
• Is a physician’s referral required for reimbursement?
• Is there a per-visit or yearly maximum, and is it shared with physiotherapy or massage?
• Can I use a health care spending account for exercise physiology?

For taxes, the CRA’s list of authorized medical practitioners for Manitoba includes physiotherapists but has no entry for kinesiologists.

What does a clinical exercise physiologist cost at Natura?

• Initial assessment: $125 (60 minutes)
• Follow-up: $70 (30 minutes)
• Individual exercise program: $200 for a four-week online training program (call to book)

Clinical exercise physiology at Natura

Lindsay Porter, B.Kin, CSEP-CEP works with people living with long-term conditions such as osteoporosis, people after an injury or surgery, people going through cancer treatment, and people who want a structured exercise program. Nobody needs to be fit before they start.

Your first appointment covers your medical history, goals, symptoms, current activity and any limitations, and may include posture, strength, balance, mobility or fitness testing. Bring comfortable clothes, supportive shoes, any scan reports or medical letters, a list of medications and any referral paperwork. You’ll usually leave with exercises to do between visits. Learn more about clinical exercise physiology at Natura, or read our guide to exercise for osteoporosis.