Before we discuss the misconceptions about thephysiotherapists in Kashmir Valley, let us understand who a physiotherapist isand what he does?
The World Health Organization (WHO) has defined aphysiotherapist as: “Physiotherapists assess, plan and implement rehabilitativeprograms that improve or restore human motor functions, maximise movementability, relieve pain syndromes, and treat or prevent physical challengesassociated with injuries, diseases and other impairments. They apply a broad rangeof physical therapies and techniques such as movement, ultrasound, heating,laser and other techniques. They may develop and implement programmes forscreening and prevention of common physical ailments and disorders.”
Physiotherapy means physiotherapeutic system of medicinewhich includes examination, treatment, advice and instructions to any personpreparatory to or for the purpose of or in connection with movementdysfunction, bodily malfunction, physical disorder, disability, healing andpain from trauma and disease, physical and mental conditions using physicalagents including exercise, mobilisation, manipulation, mechanical andelectrotherapy, activity and devices or diagnosis, treatment and prevention
This profession is badly underestimated by the people invalley and unfortunately by the doctors too.
One of the most common misconception about physiotherapy bythe people is that they think it is apart of orthopaedics which is completely wrong. Yes of course physiotherapyplays a vital role in orthopaedics but that does not make it a part oforthopaedics. Physiotherapists can treat all kind of patients like Orthopaedic,Neurology, Surgery, Cardiovascular Rehab, Respiratory rehab, Gynaecology,Paediatrics, Geriatrics and so on. So considering physiotherapists assubordinates or assistants of orthopaedicians is an injustice with thisprofession.
One more misconception about physiotherapy is that peoplethink that a doctor should refer them to a physiotherapist and they cannotconsult a physiotherapist directly. This is completely a wrong concept. Apatient can consult a physiotherapist directly and start a treatment planwithout consulting a doctor, like an orthopaedic or a neurologist. Aphysiotherapist can examine, access anddiagnose the patient independently and plan a treatment protocol. If he feelsthat the patient needs a consultation of a surgeon or any other specialist, herefers the patient accordingly. Moreover a doctor cannot write or suggest theexercises or physiotherapy modalities to a patient as they have least knowledgeof same. Physiotherapists are highly trained and qualified professionals inthis field so they have to plan and advise the physiotherapy treatment of theirown.
Physiotherapy causes weakness in patients. This is a myth.Actually patients in valley sometimes compare physiotherapy with chemotherapyand radiotherapy. Due to this misconception they feel physiotherapy can resultin severe weakness and hair loss in patients. Actually Physiotherapy iscompletely safe and free of side effects like that of medicines and surgeries.Sometimes patients fear that the currents used in physiotherapy cause generalweakness and anaemia (blood loss). But the fact is that the type of currentsused in physiotherapy are micro currents that are completely therapeutic in nature with no harmeffects. Only concern is that a patient should learn the exercises properlyfrom a qualified physiotherapist and follow his treatment plan. Wrong exercisesor self exercising can create a problem.
One wrong concept in people is that physiotherapists domassage. This is not the truth. Massage is a job of a masseur andphysiotherapists are having just the basic concept of massage therapy. In factin many cases like post fracture stiffness, acute inflammation or myositisossificans physiotherapists strongly discourage massage. Soft tissuemanipulation techniques used by physiotherapists cannot be compared to massagegiven by masseurs.
Some patients believe that physiotherapy clinic is just agym centre. People particularly from rural areas many times visit a gym centre instead ofphysiotherapy clinic. But one should remember physiotherapy is usually forpatients and gym is for healthy people. Thought a gym trainer also teachesdifferent exercises but therapeutic exercises are completely different and nogym trainer can teach therapeutic exercises to a patient.
Physiotherapists are not doctors. It is a matter of debateif a physiotherapist can be called a doctor or not? In many parts of worldphysiotherapists can use prefix “Dr” to their name. But in most of thecountries they are not allowed to. But this does not change the definition ornature of job of a physiotherapist. He still has a right to practiceindependently and make his own diagnosis and treatment protocol. So prefixing”Dr” to their name doesn’t make any difference for a physiotherapist.
Some people think physiotherapy is for sports persons only,which again is not the fact. Physiotherapists can treat sports injuries thebest but at the same time he can treat hundreds of different conditions ingeriatrics, paediatrics, neurology etc. This misconception has arisen by seeingphysios running in a sports ground to help an injured sportsperson. Commonlyseen during cricket matches.
One more myth about physiotherapy is that it is a painfultreatment. This is totally wrong concept. Actually physiotherapist can managethe pain related to different conditions in a patient much better then painkillers. Physiotherapist is vey well equipped with a no of pain controlling modalities that are 100% safe. Insome cases like post fracture stiffness etc there can be some pain but again itis a temporary pain which subsides soon after finishing exercise. For suchconditions we say ” no pain, no gain”.
Physiotherapy should be the last option and should be doneafter medicines and surgeries. But the truth is completely opposite of it.Physiotherapist should be consulted first for the best conservative treatment.Early the patient comes to a physiotherapist better are the results. And thosewho come late definitely take longer to recover. So physiotherapy has to be thefirst option not the last.
Physiotherapy is a costly treatment. Patient has to visitthe physiotherapist daily and also pay for each sitting. The fact is, a patientcan visit alternate days, weekly or monthly depending upon the condition. Thoughtpatient has to pay for every sitting but still the treatment cost is veryeconomical as compared to daily medicines prescribed by medical practitioners.Moreover physiotherapists don’t prescribe too many blood tests, scans etc. Asthey prefer treating the patients just based upon the physical examination.
It is the responsibility of the medical doctors likeorthopaedic surgeons, neurologists and other medical professionals to make thepatients aware about physiotherapy. They should not give a wrong feedback topatients by prescribing physiotherapy exercises or modalities like medicines orother tests. This gives patients a wrong notion about this profession. Theyshould simply refer the patient to a physiotherapist and let thephysiotherapist chart out the treatment plan of his own. This will bebeneficial for the patients too. Thought team work between different medicalprofessionals should always be encouraged but it should be in an ethicalmanner.
Majid Kirmani is a Physiotherapist at District HospitalBaramulla