blog

physiotherapy

Physiotherapy

galen physiotherapy
Galen performing physiotherapy

Even though acupuncturists use effective physical therapies, physiotherapy can be a helpful adjunct to our treatments.

Physiotherapy is a shortening of the term physical therapy. So in many parts of the world physical therapy is still the term for what physiotherapists do, and its practitioners are known as physical therapists.

Histories of physiotherapy point to Greeks such as Hippocrates and Galen, and claim them as early practitioners of physiotherapy (1,2) for their use of massage, manual therapy, and hydrotherapy, even though each was a doctor and surgeon. Strangely these histories do not mention their use of cupping, despite it being one of their fundamental treatment modalities. The "Father of Swedish Gymnastics", Per Henrik Ling is also mentioned in these histories, and the physical therapists he trained were known as "sjukgymnast," indicating that they used gymnastics to treat the ill * (3).

To some extent what physiotherapists do defines what physiotherapy is, and this developed as people started to use these terms. This development came as a Chartered Society of Physiotherapy was formed in Great Britain in 1894 (4), a school of Physiotherapy was founded at the University of Otago in 1913 5, the Reed College of Portland, Oregon started classes in 1911 and taught "reconstruction aides' (6), and in 1921 the American Women's Physical Therapeutic Association was started in the US, and in 1922 men were admitted and the association became the American Physiotherapy Association (7).

As the discipline of physiotherapy became established, there became a group of techniques that physiotherapists did. In the 1940s this was primarily exercise, massage, and traction (1). At first physiotherapy was practiced in hospitals and rehabilitation clinics and it remains a fundamental part of the treatment of those recovering from injury, surgery, or debilitating sickness. It was in the aftermath of the World Wars and during the polio epidemic that physical therapy became widely used (3). More recently physiotherapists have moved into private practice and many help relatively healthy people with comparatively minor complaints, or focus on sports injury and performance.

Modern physiotherapists define their discipline as the understanding of movement and function (1) and it is this expertise that separates physiotherapists from the physical therapy they perform. Physiotherapy is not its tools: remedial exercises, massage, manipulation, mobilising machines, hot or cold packs, ultrasound or TENS machines, or dry needling, it is the process of recognising poor patterns of movement, muscle recruitment, function, or posture and correcting them.

Chinese medicine acupuncturists are physical therapists. We use acupuncture, cupping, massage, and traditional remedial exercises, which are all physical therapies (8). We understand the interconnectedness of the body through systems of points and their meridians, sinew channels, and ashi points - the latter two are similar to but pre-date western therapists' concepts of anatomy trains, trigger and motor points. Using the inherent interconnectedness of our systems we can often correct patterns of poor movement or function, but sometimes a physiotherapist's approach can help, particularly by prescribing remedial exercise or teaching correct movement, posture, and functional muscle recruitment. They are experts at this as it is the basis of their training, we are experts at acupuncture and cupping, it is the basis of ours.

A consultation with a physiotherapist for an ongoing condition should involve a number of tests to identify the pathological structure, and observation of movement and posture to identify why that structure has become pathological. As well as therapies to relieve the pain there should be a plan to remediate incorrect patterns that have lead to the pathology. With acute conditions such as traumatic injuries or surgery rehabilitation there may not be such patterns, but there would still be therapies to rehabilitate and strengthen to restore proper function. For some people "proper" function may not be possible because of a disability, and physiotherapists do fantastic work helping such people cope with the physical demands of their life.

Any physical therapist who just asks where it hurts, and just treats that area by massaging it, sticking a needle in it, cupping it, or waving an ultrasound wand over it, will do nothing but give immediate pain relief without correcting its cause.

There are a number of good physiotherapists around. I use Katrina Carter at Rehub Studios in Carlton and recommend her to my clients, she's really good.

* This is gymnastics in the sense of the Roman gymnasticus, a system of exercise for health and fitness rather than the modern sport.

1 Physiopedia "Physiotherapy, Physical Therapy" https://www.physio-pedia.com/Physiotherapy_/_Physical_Therapy#cite_ref-7
retrieved 2019-5-8

2. Wikipedia "Physical Therapy" https://en.wikipedia.org/wiki/Physical_therapy
retrieved 2019-5-8

3. Medical History "The rise of physical therapy: A history in footsteps" http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2014;volume=2;issue=2;spage=257;epage=260;aulast=Shaik;type=3
retrieved 2019-5-8

4 Chartered Society of Physiotherapy (n.d.). "History of the Chartered Society of Physiotherapy". Chartered Society of Physiotherapy. http://www.csp.org.uk/director/about/thecsp/history.cfm.
retrieved 2019-5-8

5 Knox, Bruce (2007-01-29). "History of the School of Physiotherapy". School of Physiotherapy Centre for Physiotherapy Research. University of Otago. http://physio.otago.ac.nz/about/history.asp.
retrieved 2019-5-8

6 Reed College (n.d.). "Mission and History". About Reed. Reed College. http://www.reed.edu/about_reed/history.html.
retrieved 2019-5-8

7 American Physical Therapy Association "APTA History" https://www.apta.org/history/
retrieved 2019-5-8

8. This history of physiotherapy recognises chinese gong fa exercises and tuina massage as part of the development of physiotherapy: News Medical Life Sciences "Physiotherapy History:
https://www.news-medical.net/health/Physiotherapy-History.aspx
retrieved 2019-5-8