Do I need physical therapy?

CEBU, Philippines - One of the greatest fears of a person who goes through a disabling disease, such as stroke, is his diminished value in society and his potential of becoming a burden to his family. Most of us believe that when one becomes paralyzed because of stroke, he will no longer be useful and being confined in bed 24/7 can be taxing to the family. He becomes a liability to the family.

This is true, only if we allow ourselves to wallow in self-pity, remorse and depression. There is hope, and the disabilities brought about by stroke or other disabling diseases can be reversed, or in the least, be minimized with the help of physical therapy.

When one hears of physical therapy what comes to mind is either a masseur or a gym instructor. Others who may have encountered a physical therapist or two would associate the profession with stroke and paralysis.

A physical therapist, however, is more than that and the cases that they treat is so broad that in most advanced medical facilities, they can be seen in almost every department - except, perhaps with housekeeping.

The role of physical therapy in the treatment of illnesses started when man realized the potential of using physical agents like water, heat, cold, massage, joint manipulation, and exercises in rehabilitating the disabled. Hippocrates, who is hailed as the Father of Modern Medicine, for example, is known to use massage, joint manipulation, and hydrotherapy in treating many of his patients.

Unfortunately, because of the practice's nature of using physical modalities just like that in traditional and Eastern medicine, not many medical professionals see it as a legitimate part of the modern medical team. But it is.

The role of physical therapists

So, just what exactly does a physical therapist do?

 Physical therapy, according to the Standards of Practice of the Philippine Physical Therapy Association, is a profession "committed to providing quality and competent services to people to develop, maintain, and restore maximum movement and functional ability through their lifespan."

In a nutshell, physical therapists treat persons who are having difficulty moving around, thus limiting their interaction in society and diminishing their quality of life. You see, for one to be able to live a meaningful life, he must be able to interact in his community and perform tasks necessary for survival like eating and walking without any difficulty.

However, because of ageing and other reasons, some of our physical faculties become limited. Pain and muscle weakness due to disuse would now prevent one from walking, jogging, running or performing social functions that he may be used to before.

It is now the role of the physical therapist to at least minimize these effects, and with the help of other professionals in the physical rehabilitation team, ensure that one is still able to live a fulfilled life despite his physical limitations; to adapt to his current situation, to say the least.

Physical therapists, though, do not limit their interactions with people who have physical and functional disorders. They also see persons who wish to improve their physical functioning, thus they train athletes and are sometimes seen in gyms and other fitness facilities.

Fields of specialization

The American Physical Therapy Association has identified eight specialty fields in physical therapy: cardiovascular and pulmonary, neurology, clinical electrophysiology, geriatrics, orthopaedics, pediatrics, sports, and women's health.

A physical therapist who specializes in cardiovascular and pulmonary cases will encounter individuals who just had cardiac or pulmonary surgery, or such other conditions as heart attacks and chronic obstructive pulmonary disease, including asthma. The goal of the treatment is to increase the patient's endurance and to improve functional independence.

Neurologic physical therapy, on the other hand, deals with patients whose impairment, disability, or disease involves the brain and the spinal cord. The most common neurologic patients treated by physical therapists are stroke patients who may suffer from paralysis and other physical disabilities and limitations brought about by the illness. If before we believed a stroke patient to virtually have a zero chance of walking, talking, or living normally, now, with proper physical therapy, he can be rehabilitated so that he'd regain most of his physical functions and be able to live a fulfilled and independent life.

Another field of specialization is clinical electrophysiology, which deals with the use of electricity as the modality for treatment and diagnosis. This includes performing electrodiagnostic testing like electromyography, or what most of us would know as EMG. 

The elderly, most especially, benefits from the services of a physical therapist. Ageing brings with it countless conditions that would limit one's function. The last patient that I handled was a Parkinson's disease patient. Parkinson's disease is a progressive degenerative movement disorder that mostly affects people in their 6th decade of life. Boxer Muhammad Ali and Coach Freddie Roach suffer from Parkinson's disease. Since the disease is untreatable at this time and is progressive in nature, what a physical therapist can do is to delay the progress of the disease and minimize its disabling effects.

Orthopaedic physical therapy is the branch involved in the treatment of injuries and disorders relating to the muscle and bones. Very common disorders would be low back pain, fractures, and muscle strains.

Children with physical disabilities, whether acquired at birth or later in childhood or adolescence, also have a chance of living a normal life with the help of a physical therapist. Very common pediatric conditions encountered by physical therapists include cerebral palsy, scoliosis, and children with development delays.

While athletes benefit from physical therapy through specialized trainings that would further enhance their strength, endurance, and speed, while minimizing the occurrence of sports related injuries. But should sports injuries occur, which are mostly muscular and skeletal in nature, then physical therapy treatment would do the trick.

Lastly, in women's health, a physical therapist is involved in addressing health issues related to child birth and post partum care. Conditions covered include, but not limited to, treating lymphedema, osteoporosis, and urinary continence. Exercises facilitated and initiated by a physical therapist can also help in ensuring the smooth delivery of the baby.

These specializations basically define the role of a physical therapist in the field of medicine and health care, although there may be other roles that a physical therapist can play, because after all the profession is dynamic and adapts depending on the needs of the community.

A limitation for physical therapists in the Philippines, however, is their inability to diagnose diseases and prescribe treatment based on thorough assessment of the patient. Once it is discovered that one is experiencing a limitation in function, one must first seek an endorsement from his doctor before he is able to undergo much needed physical therapy treatment.

More than just a massage therapist or a gym instructor, a physical therapist addresses countless physical conditions. They are an essential part of the medical team that not just treats people with disabilities and impairments, but also ensures the optimum functioning of the body. Their practice is based on clinical research, evidence, and of course, age-old treatment methods.

A physical therapist gives hope to people who for a long time have been considered to be a burden to the family. They help these patients become independent and productive.

Physical therapy may be maturing in other countries, but in our country, the practice is still in its infancy and the appreciation of its role in the country's health system is still to be realized.

Physical therapy remains to be an option in the treatment of a patient, when in fact it should be a necessity if we want our patients to remain productive and contribute in our economy rather than be a burden and a liability to the family.

So, do you think you need a physical therapist?

If you are experiencing any form of limitation in your functioning or if you want to train your body to perform beyond its current physical capabilities, then seeing a physical therapist would be a great idea.

Sources: www.apta.org and www.philpta.org.  (FREEMAN)