Misconceptions about Physiotherapy, and Physiotherapists, in the Valley

Before we discuss the misconceptions about the physiotherapists in Kashmir Valley, let us understand who a physiotherapist is and what he does?

The World Health Organization (WHO) has defined a physiotherapist as: “Physiotherapists assess, plan and implement rehabilitative programs that improve or restore human motor functions, maximise movement ability, relieve pain syndromes, and treat or prevent physical challenges associated with injuries, diseases and other impairments. They apply a broad range of physical therapies and techniques such as movement, ultrasound, heating, laser and other techniques. They may develop and implement programmes for screening and prevention of common physical ailments and disorders.”

Physiotherapy means physiotherapeutic system of medicine which includes examination, treatment, advice and instructions to any person preparatory to or for the purpose of or in connection with movement dysfunction, bodily malfunction, physical disorder, disability, healing and pain from trauma and disease, physical and mental conditions using physical agents including exercise, mobilisation, manipulation, mechanical and electrotherapy, activity and devices or diagnosis, treatment and prevention

This profession is badly underestimated by the people in valley and unfortunately by the doctors too.

One of the most common misconception about physiotherapy by the people is that they think  it is a part of orthopaedics which is completely wrong. Yes of course physiotherapy plays a vital role in orthopaedics but that does not make it a part of orthopaedics. Physiotherapists can treat all kind of patients like Orthopaedic, Neurology, Surgery, Cardiovascular Rehab, Respiratory rehab, Gynaecology, Paediatrics, Geriatrics and so on. So considering physiotherapists as subordinates or assistants of orthopaedicians is an injustice with this profession.

One more misconception about physiotherapy is that people think that a doctor should refer them to a physiotherapist and they cannot consult a physiotherapist directly. This is completely a wrong concept. A patient can consult a physiotherapist directly and start a treatment plan without consulting a doctor, like an orthopaedic or a neurologist. A physiotherapist  can examine, access and diagnose the patient independently and plan a treatment protocol. If he feels that the patient needs a consultation of a surgeon or any other specialist, he refers the patient accordingly. Moreover a doctor cannot write or suggest the exercises or physiotherapy modalities to a patient as they have least knowledge of same. Physiotherapists are highly trained and qualified professionals in this field so they have to plan and advise the physiotherapy treatment of their own.

Physiotherapy causes weakness in patients. This is a myth. Actually patients in valley sometimes compare physiotherapy with chemotherapy and radiotherapy. Due to this misconception they feel physiotherapy can result in severe weakness and hair loss in patients. Actually Physiotherapy is completely safe and free of side effects like that of medicines and surgeries. Sometimes patients fear that the currents used in physiotherapy cause general weakness and anaemia (blood loss). But the fact is that the type of currents used in physiotherapy are micro currents that are  completely therapeutic in nature with no harm effects. Only concern is that a patient should learn the exercises properly from a qualified physiotherapist and follow his treatment plan. Wrong exercises or self exercising can create a problem.

One wrong concept in people is that physiotherapists do massage. This is not the truth. Massage is a job of a masseur and physiotherapists are having just the basic concept of massage therapy. In fact in many cases like post fracture stiffness, acute inflammation or myositis ossificans physiotherapists strongly discourage massage. Soft tissue manipulation techniques used by physiotherapists cannot be compared to massage given by masseurs.

Some patients believe that physiotherapy clinic is just a gym centre. People particularly from rural areas many  times visit a gym centre instead of physiotherapy clinic. But one should remember physiotherapy is usually for patients and gym is for healthy people. Thought a gym trainer also teaches different exercises but therapeutic exercises are completely different and no gym trainer can teach therapeutic exercises to a patient.

Physiotherapists are not doctors. It is a matter of debate if a physiotherapist can be called a doctor or not? In many parts of world physiotherapists can use prefix “Dr” to their name. But in most of the countries they are not allowed to. But this does not change the definition or nature of job of a physiotherapist. He still has a right to practice independently 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 the best but at the same time he can treat hundreds of different conditions in geriatrics, paediatrics, neurology etc. This misconception has arisen by seeing physios running in a sports ground to help an injured sportsperson. Commonly seen during cricket matches.

One more myth about physiotherapy is that it is a painful treatment. This is totally wrong concept. Actually physiotherapist can manage the pain related to different conditions in a patient much better then pain killers. Physiotherapist is vey well  equipped with a no of pain controlling modalities that are 100% safe. In some cases like post fracture stiffness etc there can be some pain but again it is a temporary pain which subsides soon after finishing exercise. For such conditions we say “ no pain, no gain”.

Physiotherapy should be the last option and should be done after 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 those who come late definitely take longer to recover. So physiotherapy has to be the first option not the last.

Physiotherapy is a costly treatment. Patient has to visit the physiotherapist daily and also pay for each sitting. The fact is, a patient can visit alternate days, weekly or monthly depending upon the condition. Thought patient has to pay for every sitting but still the treatment cost is very economical as compared to daily medicines prescribed by medical practitioners. Moreover physiotherapists don’t prescribe too many blood tests, scans etc. As they prefer treating the patients just based upon the physical examination.

It is the responsibility of the medical doctors like orthopaedic surgeons, neurologists and other medical professionals to make the patients aware about physiotherapy. They should not give a wrong feedback to patients by prescribing physiotherapy exercises or modalities like medicines or other tests. This gives patients a wrong notion about this profession. They should simply refer the patient to a physiotherapist and let the physiotherapist chart out the treatment plan of his own. This will be beneficial for the patients too. Thought team work between different medical professionals should always be encouraged but it should be in an ethical manner.

Majid Kirmani is a Physiotherapist at District Hospital Baramulla