2008-11-28 / Columnists

Eye On Physical Therapy

Commentary By Dr. Tim Rohrs

Over the course of my close to 13 years of practice of physical therapy I have been fortunate to work with many skilled and compassionate physical therapists. I try to learn from each one. Although each therapist shows skill and caring with his or her patients, each utilizes different techniques to treat. Even more fascinating is that each employs a different teaching technique. Teaching patients how to care for themselves, to stay healthy and prevent further injury occurs every hour of every day. I must admit that I am bewildered by some of their choices. In physical therapy school they encourage the students to speak to patients in language and concepts that the patient or the patient's caregiver will readily understand. I have observed some of my colleagues using language and terms straight from the anatomy, physiology and kinesiology textbook. The patient nods his or hers head, but the eyes tell the truth: She/he has no idea what the therapist is talking about. If you have been a patient of mine then you know that I love to use analogies.

It is very difficult to get an analogy to fit every situation. As the holiday season is upon us, I thought it might be fitting to use one of my favorite analogies. The time between Thanksgiving and the New Year often finds us overindulging in food, drink, and a suspension of our exercise program. Physical therapy treatments rely heavily on therapeutic exercise to restore balance to a joint or joints that have some biomechanical dysfunction. When patients have finished their course of therapy they inquire whether they have to continue with the exercises at home, and will they have to do them forever. Time for the analogy…

Our bodies are very similar to our automobiles. When we buy a new car, we pretty much count on it to run almost maintenance and hassle free for the first 3 to 4 years, save for the occasional oil change. After that time, the problems start to arise, but nothing serious. Perhaps some new brake pads will be in order, a tune up, or maybe a front end alignment.

As the car gets older, still more things go wrong. Transmissions will need fixing, new tires, and engine parts all will be required to keep that car running. The older it gets the more effort and maintenance it will need just to keep it going as simple transportation. Any car enthusiast will tell you that 25 to 30- year-old cars are just like money pits with the amount of parts that constantly need to be changed.

Our bodies are just the same. As young people, very little is required in terms of maintaining our health. For the first 20 to 30 years, it is virtually maintenance free, with little or no thought as to fitness, cholesterol, and cardiovascular or musculoskeletal system disease. We get injured and we take for granted that we will heal and get better in a few weeks. As time passes it takes more energy and effort just to keep the status quo. Regular physician visits, various medications and self monitoring are par for the course. Just like a car, it takes basic maintenance to keep our bodies running properly. We need to include exercise into our lives every day.

All body systems benefit from an exercise program that includes strengthening, flexibility and cardiovascular training. The most obvious benefits are less joint pain, improved daily living, better balance, and the ability to maintain independence in our older years. The less obvious include managing and controlling blood sugar, decreased incidence of certain kinds of cancer and improved mental health and cognition.

Now is the time to prevent the problems that are associated with growing older. It is much easier to maintain one's health than it is to try to restore it. Don't wait for the New Year, start an exercise program today. Happy Thanksgiving!

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