Physical therapy

What does the word physical therapy really mean? Regardless of the fact that the word is self explainatory, people somehow correlate it to massage.. And the question, why so, still remains a mystery for me.. 

Nevertheless, the World Confederation of Physical Therapy, defines physical therapy as services to restore maximum movement and functional ability.. 

But guess what, the day you see patients being treated you will realize its much more that we as physical therapists do, than just restoring maximum movement and functional ability.. 

We are there in the icu, making patients move to help them improve, without even needing to prove.. Complications are kept at bay, when we, are here to stay.. 

We help strentghen women, to make the process of taking care of the newborn free of physical stress.. 

We help the elderly, age more gracefully, by making them realise that age is just a number, on life’s page to remember.. 

We are who, make our patients forget what they don’t have and make them realise what they have.. We try to bring into light their strength, in order to make them forget their weaknesses.. And this is how we make things possible.. 

We are who make our patients stronger, when they think so, no longer… 

Physical therapy is the way of healing someone with not just your touch, but also with your words.. The reason I say so, is because often when we treat, we use words to motivate along with physical contact.. And trust me this works wonders.. We teach the patient, to never say i can’t and always say i can, which installs belief that helps them get better faster.. 

We are no less than a motivational speaker for our patients… We motivate our patients to the point, where they start believing in themselves.. And that’s how we get things done.. 

For days we spend time to teach our patients to stand, to walk the same way as parents do with their children.. No matter how many times it needs to be repeated, we are always there trying are best to get our patients moving.. Wonder how? Try and test our patience, with our patients.. 

We make patients stand high, when their hopes our low.. 

When we treat patients its not just about gaining range of motion or strength, its about gaining patients confidence in themselves and in us.. Its about making them satisfied with their level of functioning in their daily life.. 
Our patients would tell you forever about our contribution in their journey to get better.. 

We are who, whose uniforms soil making you realise how much we made our patients toil.. 

We are who spent our lives, adding life to lives of our patients.. 

We are physical therapists.. We heal the world with Physical therapy.. And thats our weapon.. That’s our strength..

Physical therapy, is a profession where therapists spend days, weeks, months and years just to get their patients moving.. We spend so much time with our patients, working for long hours just to get them back to daily living and still end up with poor recognition even today.. 

I guess we are too busy working to add worth to the lives of others.. But that’s all that our profession is all about.. 

And hence our profession demands not just respect but recognition all over the world..

Happy World Physiotherapy Day….

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World physiotherapy day.. 

According to World Confederation of Physical Therapy, World Physiotherapy Day is celebrated for the physical therapists, to create awareness about the crucial contribution, the profession makes to keep people well, mobile and independent.. 

This day has been celebrated in India since the year, 2009..

Today in the year 2017, we still live in a world which is unaware of our profession..

The question is, why are people still not aware of physiotherapy inspite of us spending 8 years in making people aware of our profession..? 

The reason is that, if we are trying to create awareness, it is a change in the people’s thinking and perception that we are trying to bring about.. And a change cannot be brought up in a single day.. A day out of the 365 days can be easily forgotten.. And what did we achieve by spending 8 days in 8 years talking and doing whatever we could do to make people aware of our profession..? 

Did it serve our purpose? 

No, of course not.. 

Because even today, people have the question of what is physiotherapy, and people who think they know, consider it to be just a synonym for massage.. 

No, i am not against creating awareness, on a particular day celebrated as World Physiotherapy Day but the what i am trying to say is that a change comes with time and it needs perseverance of actions.. 

So now if instead of spending 1 day in a year if we could spend 1 day per month doing something big or 1 day per week on a smaller scale, would that help? 

Maybe yes, we could always try, it would be better than 1 day per year right? 

The whole point is, if we make a difference in our patients life by spending days in treating them, then why are we devoting just 1 day to make the whole world aware of how hard we work to make our patient’s life worth living? 

People need to be made aware of what goes into making, what we make possible for our patients.. 

It’s high time, 8 years have passed and now we need to make this year a memorable one for our profession.. We need to make the world aware that we put in our patience, knowledge and skill for days, months and years together, just to add life to years, of our patients and we never use massage for achieving that.. 

Who was she? 

As always, she stepped into the ward and reported to her senior.. The senior said could you just treat the patient on bed no. 9? Yes of course, why not.. As she walked towards the bed, she saw the patient lying on the bed with the leg covered.. She knew it was a case of celluilitis.. 

She read the file and asked him, his complaints.. By his side, stood his wife answering all the questions.. She then said to the patient, lets get started with some exercises.. The patient agreed.. She kept asking questions answering which the wife started sobbing, complaining about all the problems.. Listening carefully to what the wife said, she replied.. Its okay it happens.. She knew well, that the patients wife needed someone who could listen.. And then there was a new speaker, it was the patient himself, for the first time, he finally opened up, to tell what all he had been feeling.. And now she listened even more carefully, which made her realise that the patients problem was in his mind.. He wasn’t stressed about his impairment, but about how he would be dealing with it.. 

      She made it her point, to make him realise how she could help him deal with his problem, listening to what, he felt content.. She then left saying, i want you to remember and do all that has been told.. 

      Next day, when she walked towards him, she saw him smiling, she knew, she was rendering the right treatment.. She asked him how do you feel, he said alot better.. She then said, i would like to see how well you remember the exercises taught. Before she could, move on, the patient said madam, I wanted to ask a question.. Yes of course, she said, go on.. He said, mam is it okay if i have a bath, as i am a bit apprehensive about the water entering the wound.. She replied, asking what was told to him by the medical professional, and he said, yes the doctor has told me have a bath, but I thought I should ask you once.. 

       Those words asking for her permission, for a query small as such, inspite of the authority, higher than her, telling him what to do, left her with nothing to speak.. She tried her best, to make him understand that he should be doing whatever he was told to do, by the doctor, without any hesitation.. 

       There she stood infront of that patient wearing that white coat, with a mindset and a badge of just a 2nd year Bpth student.. She was now,  being compared to a MD(Doctor of Medicine) by profession.. 

       She knew well that her knowledge at that level of education was not even worth the comparison.. But the way she portrayed the values of humanity was worth all the respect she was endowed with.. 

      That day she was enlightened by the fact that the respect she received was not for the white coat she wore, but the attitude she bore.. 

      Now, she knew the reason of her patients compliance.. It made her happy to see her patient remember all that was told to him.. 

      Her happiness knew no bounds, because now she exactly knew, who she wanted to be.. Her patient himself, defined her worth.. What more could she ask for? 

      All she did to get that respect was, she listened to whom, no one listened.. Cared about whom, no one cared.. 

She was the patient’s physical therapist.. And now she knew her real identity.. 

Why do i care? 

   Often people ask me, why do I go to the wards and check upon my patients regularly.. They ask me, do you get emotionally attached to your patients? And honestly I prefer to keep quiet, and let the silence answer this one.. 

   Well the truth is, its not about getting attached to a particular patient, its about caring enough about the patient you’ve been treating in the hospital for a while.. Its about checking on how their improving.. It makes me feel good to see my patients improve.. And it isn’t a sin, right? 

   It’s not about, being emotionally weak, that makes me feel my patients pain, its about me being a human.. The fact is that I’m not just a therapist, but also a human.. I agree to the fact, that getting deeply involved with a patient, so much so that, it starts affecting my personal life, isn’t a good thing for me.. But for me, it’s just that i care.. And I still have a personal life, trust me.. And guess what? This is exactly, what has helped me gain respect for that white coat that I wear.. It was never for those marks that I achieved, it was never for the treatment I gave, it was just the way I made them feel, I cared.. 

    Infact whatever I do for my Patients makes me worth their rememberance.. And this is the most precious thing for me.. If my patients could remember me for how much I cared for them, in times of their need, it makes me a successful therapist.. Thats all I know.. 

    I don’t know why, people fail to realise that a patient would understand your ability of being a great medical professional on the basis of their(patients) own knowledge.. And their knowledge is very limited in terms of their right treatment.. No matter what treatment I give, the patient would always judge me only on his/her own knowledge..

     Every therapist learns the same things and has the same amount of knowledge, leading them to get their degrees, right? 

    The question is, then why do patients prefer a particular therapist, to get themselves treated? 

   The reason is, it’s not the treatment, but the way you treat and care for the patient, that helps them judge how good you are at your job, because this is exactly the extent to what their knowledge is limited to, and that is what makes you worth their rememberance.. 

     And this is why, i check on my patients regularly, to let them know, someone cares.. And this is something they would remember me for, not for the treatment.. 

     Most of the times patients and relatives complain that no one listens and no one cares, and when I do, they value it.. I give my patients what they need.. And that’s all, that is required for them to feel better.. 

    This is what I want my patients to feel, and this is what defines my worth as a therapist in my patients mind.. That is all I care about.. 

    Where people belong to a profession same as that of mine, where the patient is the main priority, a question as such could still arise? 

    Why do you check on your patients regularly? Well because, MAY BE THATS MY JOB… 

Principles of treatment.. 

In physical therapy, patient’s with a neurological problem are often treated with respect to 4 principles

  • Mobility
  • Stability
  • Controlled mobility
  • Skill

The patients are supposed to be trained through each stage in this exact order..

According to me, we could treat every patient with these principles, but the only difference being that we change the meaning of all the 4 principles just abit.. 
Also this time, these stages would refer to the therapist rather than the patient..

Now according to the books, mobility is the first step and it works on the range of motion.. I believe, mobility is the way you treat the patient.. By the word treat, im not referring to the actual treatment but the way you treat (behave with) the patient.. 

  • Its about how you talk to the patient, to make him comfortable, when you see him/her for the first time.. 
  • Its about how easy you make it for the patient, to open up and tell you about his complaints..
  • It’s how you can actually win the trust and confidence of the patient in just few minutes of the first time you meet him..

Next is stability, in books this refers to the muscle strength, which is important to carry out function..

According to me, stability is the strength in the relationship, the therapist – patient relationship.. Now what do I mean by strength in the relationship? Basically, strength is achieved by

  • The bond you create between the patient and yourself, which is based on trust.. 
  • The trust that the patient has in you as a therapist.. How much does he trust you? Would he do everything you tell him to? This is why trust is important.. Its the basis of this relationship.. This would actually determine patient’s compliance..
  • The trust the patients relatives have in you.. This would determine how well they listen, to what you have to say and do as you say..

For stability to develop you need mobility.. Just the way you use mobility to build strength(stability) in muscles of the patient, the therapist needs to use mobility to build stability as explained above..

Stability is followed by, controlled mobility.. In the books this refers to the control of the movement… How well the patient can control the movement.. 
I believe controlled mobility refers, to the knowledge of the therapist of knowing when to do what.. By this what I mean is, the therapist should know exactly, when to control and what to control, i.e, when to push the patient upto his physical limit and when to make use of the patient’s emotions to push his own self.. It is the knowledge to be able to control the fine balance between the physical ability and the emotions of the patient to achieve his set goals..

Controlled mobility would help you build, your next step as a therapist..  

Next is skill, which refers to the ability of the patient to perform a certain complex task efficiently ..

I believe, it refers to the ability of the therapist, to achieve the goals set for the patient.. 

  • It depends upon therapist’s ability to know, how to persuade a patient who is reluctant to exercise
  • It depends on how well the therapist puts his knowledge into action to treat the patient
  • It depends on therapists ability to make use of patients emotional needs to achieve his own goals
  • It depends on therapist’s ability to be able to push the patient to his functional limits everytime, to achieve what he wants..
  • It depends on the therapist’s ability to understand where the actual problem lies, whether its in the mind or the body and then treat it..

Now the question is how do we actually make use of these principles in our practice?

Mobility can be achieved, by just conversing with the patient, making him comfortable in just a few minutes of you meeting him.. This would help you make the patient open up to tell you his exact complaints.. It is not what you do, but how you do that really matters… Just the simple way of talking to the patient, makes the difference.. Just the caring tone of your voice, when you talk to the patient, helps the patient become more comfortable and that’s exactly what you want.. 

Stability, can be achieved by just getting to know the patient well, talk to the patient, ask them questions, doesn’t have to always be about their condition, it could be about their life, their family, their work, their likes and their dislikes, it could be about how their condition makes them feel, how it has affected their lives.. This is what, helps you know them better and create that bond, and trust, which you want them to have in you.. 

Controlled mobility can be achieved by knowing when your patient, needs your help and when, you need to actually push him, by motivating him to achieve his goals.. Its about knowing how you can help your patient, without letting him be dependent on you.. The therapist should now when to support the patient, and when not to… This is something you build up on, as a therapist, with experience.. 

Lastly, skill.. Just the ability of the therapist to poke the patients emotional needs, to make him work harder determines the therapist’s skill.. Skill can be achieved with knowledge based on practice and experience.. Its not something that can be taught, its something that you as a therapist, would learn all by yourself.. Every patient is a different one, and each of them would teach you something new.. This is how you build up your skill.. It is this quality, that the patient admires you for, and the reason he would choose you, over others as a therapist and would always come to you, for treatment.. 

As a therapist, we need to start using these principles for ourselves, to be able to treat our patients better.. 

    Don’t forget to treat the human relations..

    One of the most important things we often forget as therapists is the fact that we are dealing with humans… Humans have relations… Patients we treat are usually accompanied by their relatives, because the health of the patient affects his/her relatives as well.. 

             Most of these, are the closet relatives of the patients, so anything that happens to the patient leaves a great impact on them.. The only difference is that it affects them mentally.. We as therapists, fail to realise that sitting beside the patient who is unconscious or maybe conscious but severly affected by his impairments, isn’t an easy job.. It takes alot of mental strength on the part of the relatives to control their emotions and not give up hope, by the patient’s physical condition..

             Every time I visit the hospital I wonder how hard it is for the relatives to spend days with the hope to see a change in the patients health… 

            Having realised it, i made it a point to consider it my duty to councell the relatives, along with the patients.. They are the ones who could take the best care of my Patients provided they themselves are mentally strong… I cannot be 24hrs with my Patient but they can and they do… 

             It’s takes a strong person to teach you how to be strong, isn’t it? 

             Quiet often I see relatives look up at me as an answerer to all their questions, because they are never encouraged to get their questions asked by other treating medical professionals.. Often I ask them.. What did the doctor say? And the answer is “nothing”.. For me, I like to give them the opportunity to ask, and I realised, this is when they open up… The day you ask them about any queries they might be having, they feel they can trust on you… Thats the trust I want from them.. They ask me questions because they know I have the time to answer them… And I feel good about it.. After all its their right to ask and my duty to answer every question I can… 

             It’s important to build a rapport with the relatives, get them out of that circle of mental stress they are in.. This would help you create a positive environment for your patient… 

            Making the patients and their relatives feel better, telling them how the therapy has already started showing signs of improvement in the patients is important.. This installs their confidence and trust in you… As a therapist what else do you want?

             The key is to understand that, its alot harder to wait and just keep waiting without a reason… Give your patient’s relatives the reason, and see the difference it makes.. It makes your job and their responsibility an easier task…

           You see its important to not only, treat the humans but also the human relations.. 

              

    It’s all about loving what you do.. 

               No I’m not exaggerating my feelings, but honestly, its taking me time to fall asleep these days.. When I get into bed all tired, and think about my day, all I remember, is how i made my Patients feel for the day.. Were they happy, did my presence make a difference in their lives for good? If not, what more can I do? This question, actually keeps me awake for most of the time.. 

             For all the times I’m not satisfied with the results.. I try to find answers to the why.. Why did my patient not improve? Most of the times, i come with the answers myself, but sometimes I get these answers from my seniors or my teachers.. 

            I realised, there is so much to learn and the majority of it comes from your patients

            You see, every patient is unique in his/her own way and hence the way of treating each patient is different from the other and teaches you something new..

            Your patients, teach you ways you could improve yourselves.. Trust me this is the best part.. When I started treating patients, I realised they taught me how to treat them.. They made me realise that the best way to treat them is to first imagine yourselves in their place and then ask yourselves, how would you like to be treated? The answer you would come up with, is exactly how you as a therapist should be treating your patients.. 

             My Patients, have helped me grow myself into being a better version of me… I don’t know, if this is all natural, but honestly my love for my profession, has taken me to a next level… I have started enjoying the time I’m with my Patients, so much that I don’t feel like leaving the hospital… 

            From making them stand for the first time, to the times when they open their eyes and regain their consciousness after days of physical therapy, has given me what makes me love what I do… 

            There are days, I end up getting emotional seeing my Patients or their relatives cry, but guess what, I realised this isn’t a bad thing, its not that I’m emotionally weak, infact this is why I can treat them better.. The day you feel what your patients are going through, that day you know exactly what to treat and how to treat… 

            A change in my postings, makes me sad, the only reason being is I hate to leave my Patients.. After spending quite some time with them, you end up bonding with them, and then leaving them in the midst is just the worst thing… But, you know what’s the best thing? It’s when the patient doesn’t want you to leave.. This is a real patient – therapist relationship, it is this kind of a bond which you should aim to build.. 

            It’s weird how you start feeling for your patients, working to make them get better, some how gets you closer to them on an emotional level… 

          As I always say, consider the fact that patients are humans… All that your patients need is your time, love and care.. Give them what they need and see them rise.. After all this is what we live for… 

           We live, to make our patients life,                                   worth living.. 

    This is why I am a physical therapist and I am in love with what I do..