Physiotherapy Beyond Machines!

By Shailesh Kumar Singh, Sr. Physiotherapist AIIMS New Delhi

Physiotherapy is thought to be a supportive mode of treatment whereas according to the definition given by WHO, DCPT, and Healthcare Profession Act, “It is an INDEPENDENT PROFESSION in which a physiotherapist practices by undertaking comprehensive examination and appropriate investigation, provides treatment and advice to any person with movement or functional dysfunction, malfunction, disability, and pain from trauma and disease, using modalities, exercises, mobilization, manipulations, for prevention, screening, diagnosis, and treatment.

Despite the definition given by these reputed institutions, there is still a lack of awareness about the different treatment approaches that a therapist uses to treat a patient not only among the common public but also among the health stakeholders therefore physiotherapists receive a referral with already written treatment including only machines and basic exercise which is been in practice for more than 70 years now and making the gap between conventional physiotherapy and advance physiotherapy deeper.

Physiotherapy had been started with more reliance on machines and thereby offering only diplomas earlier but with the passing of time the bachelor’s degree has been started and later on looking into the role of physiotherapy in specialized areas masters in different fields viz; MPT in Neuro, ortho, obs and gynae, sports, pediatrics, oncology, etc have been started like we have different MDs after MBBS. Ph.D. is also now being offered in physiotherapy as the research in the field has shown accelerated growth.

We need to understand that the equipment which is been used in physiotherapy is only to give temporary relief but not to provide a permanent solution for the primary complaint which is possible only with a bottom-up approach that means assessing the patient thoroughly and then planning the treatment accordingly.

A physiotherapist uses his extra ear that means his hands for the assessment of the patient includes not only the history of the primary complaint but also looking deep into the local structures giving that symptom while keeping in mind the far-off structures that could be the contributing factors for the problem thereby reaching to the root cause of primary complaint rather than a superficial treatment of just the symptoms.

After the assessment comes the role of evidence-based treatment for the condition which includes the re-alignment of the joints, and bones, manual releases for the tight fascia and muscles, realign scar tissues that can get in the way of your body’s full range of motion, manual lymph drainage, etc using manual therapy, osteopathy, dry needling, Kinesio tape, cupping therapy. etc with the individualized exercise program which ultimately leads to chucking out the root cause of the primary problem which is giving those superficial symptoms and thereby providing the patients a permanent solution to their problem and reduce their need to visit the physiotherapy clinic again and again for the same problem that frequently happens with the use of only physiotherapy machines rather than wholesome approach.

For Example: A patient comes in with pain in the back radiating to the right lower limb. so the conventional approach for the case would be using diathermy, ultrasound locally, and IFT for pain relief along with traction giving the patient symptomatic relief rather on the other hand, in the advanced physiotherapy approach, the physiotherapist will assess the patient for the root cause of the symptoms .he will take a detailed history and later on a detailed assessment by looking into the posture of the patient is in because of the pain, the gait pattern, muscles in spasms, muscles which are short with trigger points, the mobility of the spine not only the lumbar spine but the spine as a whole with the areas of hypomobility and hypermobility, alignment of the nearby joints like sacroiliac joints, hip joints, pelvic bones, fascial restrictions, breathing pattern, abdominal viscera movement, etc to reach into a clinical diagnosis and thence start with the individualized treatment protocol.

So physiotherapy is already been shifted from mere dependence on the equipment with a blinded approach to a more scientific approach using novel techniques making it a full-fledged system in itself. This treatment approach is time taking so the patient should understand the need for the same, should be compliant and vigilant to what is happening to their system and what should be done to help them come out of their suffering permanently. So in the end a small request to the patient” Don’t let your body be fooled by masking your symptoms rather love it to the fullest by giving it the gift of the right treatment”