Background: Body communication (traditionally known as non-verbal communication) is intrinsic to physiotherapy practice, and particularly in the private practice environment where drivers such as economics and consumerism can influence the pace, and by association, quality of body communication. Existing literature has focused primarily on verbal communication, with little attention given to body communication and in particular, consideration of how body communication influences and co-constructs the patient-physiotherapist interaction.

Aim: The aim of this qualitative study was to explore the key role and impact of body communication in private practice physiotherapy in New Zealand, focusing specifically on the interaction between patient and physiotherapist.

Methodology and methods: Interpretive Description informed by social constructionism was employed to frame this qualitative study exploring the role and impact of body communication in private practice physiotherapy in New Zealand. Two patient/physiotherapist dyads were recruited to the study. Sessions were observed and video-recorded and field notes were taken. Post-session video-stimulated recall, semi-structured interviews were undertaken and analysed for themes. Video-recorded data was analysed using part process analysis and thematic analysis.

Findings: Two themes were constructed. The first theme, atmospheres matter described how the physiotherapists’ body communication played a key role in creating clinical atmospheres that shaped the relationship between patient and physiotherapist. The second theme, tailoring physiotherapy practices, highlighted how body communication was a medium through which physiotherapists tailored physiotherapy practices. The physiotherapist’s skill at tailoring their practices to each patient’s unique needs and expectations was crucial in engaging patients in therapy and building the therapeutic relationship.

Discussion: Body communication played a crucial role in patient-physiotherapist interactions and significantly influenced the therapeutic process. Specifically, body communication mediated physiotherapy. That is, body communication could assist both the patient and physiotherapist to overcome challenging situations, or it could have potentiating effects, making conditions more positive (or negative). Consequently, increased awareness of body communication and the importance of its use will improve both the patient-physiotherapist relationship and treatment outcomes making it an important skill for physiotherapists to develop.

Conclusions: The findings provided detailed and nuanced accounts highlighting how sensitive and responsive body communication supported physiotherapists to implement a more person-centred approach to communication and enhance therapy outcomes.