AN ultrasound machine and one room is all physiotherapist Elaine Atkins started out with.o

She now treats people from across the Epping Forest district at her three practices, Elaine Atkins Associates, in Traps Hill, Loughton, the David Lloyd club, Chigwell, and in Woodford.

Starting out 29 years ago, Dr Atkins relied on word of mouth for business. After borrowing £1,000 from her brother, she set up her first physiotherapy centre in Leytonstone.

Dr Atkins is modest about her achievements but maintains the attitude that physiotherapy is a professional discipline, with a big role to play in health education.

"We have got away from the image of physiotherapy being a slap and tickle thing. It used to be all women in the profession, now men and women are equal in numbers.

"Physiotherapy actually started in 1894, when a group of nurses thought they would make massage respectable. Physiotherapy comes from massage, which then moves on to exercise and the inclusion of electrical treatment."

Dr Atkins explains that physiotherapy is not just for sports injuries and back pains but can help women with those little problems we all get too embarrassed to talk about.

"A lot of women are affected by stress incontinence. This mainly affects women above 30, and can be triggered by pregnancy, which makes the pelvic floor muscles not work as well.

"This can be an embarrassing problem but there is a lot people can do. This is a bit of a 'no go' area for some people. We think we are so educated and enlightened but people must not suffer in silence."

Dr Atkins, who trained for three years at St Thomas's Hospital in London, said: "There is a strong emphasis on having a degree in physiotherapy and you need good A-level results, like two As and a B, but there are also circumstances where you can train as a physio assistant. People need to know that experience must be valued.

"I would always advise people to look for some sort of work experience. This can be in a hospital, nursing home, or a special school," she said.

Associate physiotherapist Sue Cooper has worked in the field for 21 years, training at the former Prince of Wales Hospital in Tottenham.

She explains that the Loughton practice does a lot of outpatient muscular skeletal work. "We see a lot of back, necks and sports injuries, and arthritis, which can affect both sexes."