Being Physio: Physiotherapist at Work
A real story or shall we say slice of life from a physiotherapist who was pronounced as the best physiotherapist by her own patient? Afterall, what it takes to being a physio?! Read on, in her own words.
During our college days when we were being trained to be a physio, we were told a story. It was about this huge ship which gets stuck in the middle of the ocean. No one among the marine engineers on the ship could rescue the ship. Help was sought from far and near. But absolutely no one could help. After a while when all the efforts start to seem waste, someone suggested a local mechanic staying on a nearby island. Not leaving any stone unturned, he was brought to the ship. This poor local guy comes, observes and examines the engine and then takes out a tool out of his backpack and taps a few times on a particular area of the engine. To everyone’s surprise engine starts whirring in no time. When they ask him about his service charges, he demands a big amount. No one expected a visibly poor and local basic mechanic lacking any fancy degrees to charge so much. When he demands such an amount, they ask him for the split of the services to justify the bill. He calmly replies, “The technique I used to solve your problem doesn’t cost much, but having an understanding and knowledge about which technique needs to be used for this particular problem and how effectively it needs to be used is costing you so much.”
Likewise, in-spite of Physiotherapy being such an effective intervention, it is often highly under-rated. Owing to the system of billing per session, the service charges of a physiotherapist are not based on the overall treatment for relief and recovery of the patient. Instead, they are always being judged based on the amount of time spent per session and the total number of sessions required for complete recovery of a particular condition. Hence, today I take great pleasure to share one my recent and pleasant experiences, after being in this field for more than 7 years.
Some time last year, I happened to have this patient at ReLiva Physiotherapy clinic, Nerul. This patient in his early late 30s came to me with his chief complaint of lower back pain. “Yes, lower back pain!”
Lower back pain or LBP as we call it, is kind of very broad terminology. To top it, it is not even a real diagnosis! My fellow physiotherapists will understand when I say that. Afterall, lower back pain is just a symptom of which a patient complains, when there is some structural pathology happening at his lower back area.
My patient had been facing this pain for a couple of weeks. Since he belonged to a profession which demands prolonged sitting at the desk, his pain had been further aggravated. He had visited a doctor, he had taken painkillers and also, he had undergone Physiotherapy sessions, where he was given therapeutic currents in order to relieve a muscle spasm, but all these gave him only temporary relief. The day his painkillers course got over, he would start having the same pain all over again.
On further probing about how his pain started and if he had any history of trauma or a fall, he told me about this event where he did mountain biking, exactly after which this pain had started. Also, he added that mountain biking is his passion and he loves it. To top it all, he had an event lined up in next couple of weeks which he absolutely didn’t wish to miss! He wanted to recover as soon as possible and attend this upcoming event. I was shocked and amazed at the same time, looking at this person who is in so much of pain, that on asking to grade his pain he rated it 8/10 on NRS. He was actually showing a limp in his walk as his pain was unbearable. This person in so much pain was asking me to help him, so that he could do the same activity all over again, which had put him in this situation, in the first place. But, as they say, where there is a will, there is a way!
After a thorough assessment and physical examination, I was suspecting that he had one sided Sacroiliac joint dysfunction, which I confirmed with a couple of special tests and we started with our therapy sessions. This session comprised of one mobilisation technique which I was supposed to do manually on his sacroiliac joint passively and one movement he was supposed to do by himself, actively. After several repetitions, I noticed, the quality of his active movement had improved slightly. Even he could feel it. This was a sign for me that yes, I am going in a right direction. For, if I was doing anything wrong, the patient would have complained of increase in pain instead of pain relief and improvement in quality of movement. This was a big relief!
[ Related Reading: SI Joint / Pelvic Pain – Do’s & Don’ts ]
To conclude the session, I taught him the same technique but in a different position so that he could do that at home on his own, for the next day before visiting me for his next session. I also explained him about certain dos and don’ts.
He religiously followed all the instructions. The very next day when he visited me, he said he has almost 50% of pain relief and that sense of coming out of that painful zone was really great! We continued with our therapy sessions for another 3-4 days and on 5th day he was completely out of back pain, rating his pain level at 0/10. Hurray!!
During these 5 days of treatment sessions, I always had to keep in mind not only his pain, as it was his chief complaint, but also his long-term goal that he wished to attend the mountain biking event, upcoming in next couple of weeks. On the last day of the therapy, I taught him few back strengthening exercises as well and discharged him with my best wishes. He looked really satisfied and happy as he was totally pain free.
After a month, one very fine day he happened to visit me in the clinic again. But this time he was visiting only to express how thankful he was to, as he could do the mountain trekking on his bike with no pain at all! He said, he still performs all the exercises regularly and now he knows if such an episode happens then what kind of home exercise program he has to follow. Those words of satisfaction meant a lot to me.
In this case, not only knowing ‘what to do’, but having an understanding and knowledge about ‘where to do’ and ‘how to do’ had helped me gain good recovery in this patient. Also, I am glad he kept his full faith in me and cooperated throughout.
This post is a memoir, contributed by Dr Shraddha Gangan (PT), a physiotherapist at ReLiva Physiotherapy. Dr Shraddha is committed to her profession and finds happiness in her patient recoveries across a spectrum of sports injury, musculoskeletal and post operative cases.