Physiotherapy might not be your first thought if you find yourself in the intensive care unit but a recent review of high-quality evidence on the subject shows that physiotherapists have much to offer this group of patients. Weakness develops extremely commonly and quickly when acutely ill patients are ventilated in intensive care. The weakness affects the muscles of the limbs and trunk, but also the muscles responsible for breathing. There is a range of interventions that physiotherapists can use to combat the weakness - and these interventions start early.