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“Pain is a personal and unpleasant sensory experience,” according to the National Institute of Neurological Disorders and Stroke.
“Pain is subjective, so is its intensity. Its impact may vary from each person. Pain may also signal an underlying medical condition. Effective pain management depends on proper assessment to identify the source of pain for appropriate treatment,” said registered physical therapist (PT) and certified stroke rehabilitation specialist, Mary Christine Domingo.
We are, however, vulnerable to quacks lurking everywhere, offering rehabilitation and pain management programs. Let us be wary and make sure that we get proper management from legit physical therapists. According to RA 5680, or the Philippine Physical and Occupational Therapy Law, “Physical therapy is the art and science of treatment by means of therapeutic exercises, heat, cold, light, water, manual manipulation, electricity, and other physical agents.” It is prudent to request for a PT’s license issued by the Professional Regulation Commission to show proof that they are legally qualified to provide assessment, diagnosis and intervention to people with different medical conditions and impairments such as musculoskeletal conditions, cardiovascular conditions, neurological conditions, and sports injuries (ex. sprains, strains, fractures and dislocations).
Let us address one area of confusion. Are PTs the same as fitness coaches?
“A physical therapist is a person who must have a bachelor’s degree in physical therapy, and who is legally qualified and licensed to practice physical therapy. On the other hand, a fitness coach or a personal trainer is someone who underwent a certification to help individuals to achieve their fitness goals such as weight loss, improve their muscle strength and endurance, and athletic performance. They can also teach clients on how to execute the exercise better and can create workout programs based on the client’s specific concerns and fitness level. However, they cannot treat medical conditions,” explained Domingo.
Is physical therapy only for the injured individuals? Who needs physical therapy? According to Domingo, physical therapy is not limited to individuals who have experienced injuries to the knees or back, sprains, and the like. Healthy individuals who wish to improve their overall strength and conditioning can benefit from physical therapy. This is because PTs are movement experts with a strong foundation in the anatomy of the human body, kinesiology, which is the study of human movement, and in rehabilitation.
When does one need rehabilitation? “Rehabilitation is the process of re-teaching or restoring the skills that individuals already have learned before the injury occurred,” said Domingo. For instance, a stroke patient and a patient who had a traumatic brain injury would need to undergo rehabilitation to regain strength from sitting to standing with proper balance.
Patients who had a stroke or traumatic brain injury may have a loss of sensation. However, at the other end of the spectrum, many individuals suffer from terrible pain sensations at the same time. It is important to identify the root cause of the pain and get proper management. When it comes to physical therapy, the principle of different strokes for different folks must apply. Individualization of therapy is vital to the desired outcome.
“If a person has a nerve injury, overstretching can aggravate the symptoms, so we can perform Nerve Flossing or Neural Gliding, which is a technique that requires slow, gentle, and repetitive movements to allow the nerve to move to release the tension. If a person has muscle pain, avoid overstretching or doing motions that will exacerbate the symptoms even more; instead, perform the motion in a pain-free range,” explained Domingo.
Several techniques may be used to manage pain, including heat and cold therapy, electrical stimulation, joint manipulation, and mobilization. Among these, therapeutic exercises play a key role in reducing and managing pain.
Certain movements or exercises should be avoided depending on the individual's condition. For example, someone with low back pain may feel discomfort when bending too far or when standing for a prolonged period. In such cases, it is important to know the precaution and to perform the exercise within a pain-free range. Another example is people with osteoporosis. They should avoid excessive bending or flexion movements, and the combination of flexion and rotation movements to reduce strain and the risk of fractures.
Domingo mentions another type of therapy which is called habilitation – a process of teaching a new motor skill for the first time. This is often associated with children. For example, a child diagnosed with cerebral palsy and Down Syndrome needs to learn how to walk. Healthy individuals who belong to the older adult population may also benefit from habilitation therapy as well.
“Our aim is to restore or maintain function, and to teach them how to prevent falls and other injuries through mobility exercises, balance exercises and strengthening exercise,” said Domingo. Simply put, physical therapy is not just for treating injuries but also for preventing injuries.
If you are experiencing chronic pain, have yourself assessed by a professional. If you have an injury, seek the help of a registered physical therapist. When it comes to your health, don’t take chances. Let a professional take care of you.
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