What does it mean to be a physical therapist?
I am a physical therapist, and I’m proud to call myself that. It is a profession where you actually try to understand and fix people’s problems.
It takes a lot of time and effort to master the craft, and the work itself is surrounded by a lot of mystery. So let me debunk a little bit of it. Once I decided to study physical therapy, I was blinded by the upside. What I saw in it was the ability to heal people with your bare hands and what most of the patients in the field assume it to be is massages. Yes, we do massage, but it’s just 5 per cent of the therapy. The other 95 per cent is educating, manipulating joints and teaching exercises. If the physical therapist is giving you massage and feels good, then he or she is doing a lousy job.
Our goal is to make your move since if you don’t, you will be stuck in the loop of pain and sickness. Through my work, I had pregnant women, paralysed kids, patients with broken necks, hips, fingers or any other imaginable joint and patients with psychological issues in treatment. In the acute stadiums, the goal is, in case if you deal with elderly people is to make them breathe and walk. In sport-specific therapy, my goal is to make the athlete exceed their skills. Some patients just come to talk. And that’s the beauty of the profession. Even if it said that we are just fixing the body, we do set the whole. It is impossible to stay healthy if you don’t believe in yourself.
Yes, we accompany our patients through pain, misery and loss. Even a depressed patient will have to get the curve. Otherwise, the pain and lack of movement will increase his or her depression. In this profession, you have to be selfless, and most of us suffer from the helper syndrome. In our curse, the dropout rate was very high. Almost half of the students went. And the way physical therapy is taught in Germany also differs from most countries. We got exposed to patients after one year of training. We were sent directly to the hospital and didn’t take us long to be left alone with the patient. It was overwhelming to interact directly with patients. Who had been through various operations in huge pain or blankly insane. It is something you don’t learn in economics classes.
If a person is in pain for a very long time, then they have a tremendous sense of empathy. They will ask you about your day and health. People who have been in pain for a short amount of time don’t have this kind of self-awareness. All they do is very self-centred. They crave your help, it sometimes feels that they even don’t see you as a person. But more as a tool. I had a patient whose leg was amputated because of severe diabetes. My goal was to make him walk. And I tried Everything from forearm crutches to a rolling walker. He just couldn’t stand, his muscles were too weak. But still every day I was there early in the morning by his side. Motivating and trying.
One day he couldn’t hold his balance and accidentally he had to rest his leg stump on the floor. The pressure was too high, and it caused bleeding. Another part of his leg had to be amputated. Another patient of mine broke his legs as he tried to commit suicide by jumping out of the window. He was old, but there was still hope that he could walk again. And I was there, helping him every day. We were practising steps and training his leg muscles. And he made excellent progress. It was that good that he was able to walk on his own within his room.
So he walked up to a window and jumped again. It was his last walk. Even if the work is tight and you do Everything in your capacity to enable people, you still will never know what the outcome of your efforts will be. You can show a sportsman how she or he can squeeze the last bits out of their performance to then see how they get injured. Physical therapy is a tool and a compelling one. Since you get taught a skill just as the saying goes:
“You buy a poor man a fish, and he will be fed for one day but if you can teach a poor man how to fish. He will be fed for his whole life.”
And that is what we do. We give people skills that enhance them. But it is up to the person on how they use it. Another saying goes:
“Use it or lose it.”
Which is an aphorism for the fact that our body is adaptable. And we adapt to all the stimulus that we get day by day. Even if we don’t get any incentive, our body also adapts to that. This is the reason why so many office workers suffer from back pain. They simply got changed to the fact that they sit every day. Just as the basic understanding of health is very misleading. Health is not the absence of sickness. It is adaptability. The more you can adapt to any stimulus, the healthier you are. It is a bit more easily understood if I use the water bucket metaphor.
An empty bucket is easy to carry and light in weight. But once you add water to it, then the bucket becomes more and more immovable. You are the bucket, and the water is sickness, it can be a systematic health issue like diabetes or heart disease, a disposition of a joint reversible like a malposition of a bone or irreversible like a fractured bone. Just as much stress is a huge factor that slows you down. Here is a quote from the book
Women, Food and God: An Unexpected Path to Almost Everything it makes it visible how stressed a day to day person is:
“When you believe without knowing you believe that you are damaged at your core, you also believe that you need to hide that damage for anyone to love you. You walk around ashamed of being yourself. You try hard to make up for the way you look, walk, feel. Decisions are agonising because if you, the person who makes the decision, is damaged, then how can you trust what you decide? You doubt your own impulses, so you become masterful at looking outside yourself for comfort. You become an expert at finding experts and programs, at striving and trying hard and then harder to change yourself, but this process only reaffirms what you already believe about yourself — that your needs and choices cannot be trusted, and left to your own devices you are out of control (p.82–83)”
― Geneen Roth
Long story short, your adaptability is determined by the amount of water(negative stimuli) you have to deal with.
So what we do in the physical as Wendell Berry said “People use drugs, legal and illegal, because their lives are intolerably painful or dull. They hate their work and find no rest in their leisure. They are estranged from their families and their neighbours. It should tell us something that in healthy societies, drug use is celebrative, convivial, and occasional, whereas among us it is lonely, shameful, and addictive. We need drugs, apparently, because we have lost each other.”
So, what do we do in treatment? We empty your water bucket. And by doing so, we avoid using drugs, just something profound as guided Muscle relaxation according to Jacobson(Link) or manipulation of an upper spine.
The work of a physical therapist is tough; it requires a humongous amount of humility and humbleness to be able to survive in this profession. You make a lot of mistakes, and you see how different every individual is. In the way, they approach their problems or what kind of questions they have. You are the one who is supposed to resolve them, you should be able to focus on every individual for a duration of therapy with all your consciousness.
That is very hard since at that moment your problems don’t count. It doesn’t matter that you are in-depth your wife is about to leave you, and you got diagnosed with cancer a week ago. Once you are in treatment, then the person in front of you matters. He or she came to you personally because they have a problem, a problem that they can’t solve alone. You give your best.
Since you are just as good as your last treatment. And this is why I’m proud to be a physical therapist. In this profession, I’m always thriving. You learn a lot about yourself and most importantly, about how different every individual is. You see how much suffering you can prevent and what it means to work for your health.
Since I always say:
“The best way to cure cancer, is to prevent it.”