Physiotherapy FAQS

Physiotherapy is a rehabilitation program that is advised to patients to help improve mobility and function of a specific part of the body. On your first appointment, the following is to be expected:
 A detailed history of your surgery/injury/condition that requires physiotherapy including any pre-existing medical conditions/previous surgeries.
 List of current medications you are taking
 Clinical tests to identify potential & existing problem-areas.
 Any additional notes made by the physician before planning your physiotherapy plan

Once your physiotherapist is well-informed about your ailment, they will examine you to assess the extent of physiotherapy required. For instance, if you’ve come due to a lower back pain, they will ask you to bend forward and backwards to gauge the range of movement & note them downin case they are causing an acute pain/discomfort.

Your first session may be either a single therapy or a combination of two or more, depending on your presenting symptoms. Therapies include hot fomentation, cold compression, USG-physiotherapy, acupuncture and/or isometric & dynamic exercises, etc. 
 

A physical therapist is a highly-trained medical professional who helps in restoring mobility & function, reduce pain and/or prevent disability. In most cases, an intensive physiotherapy plan conducted by a skilled physiotherapist rules out the need for interventional surgery and helps reduce the need for long-term medication.

Physical therapists diagnose and manage multiple conditions that reduce quality of life. These include any movement dysfunction, chronic pain especially in weight-bearing joints, post-operative recovery, etc.  
 

Depending on your condition, there are several treatment options available:

 Hot fomentation- In painful conditions, such as lower back pain, hot fomentation is given to relax the muscles and initiate healing due to increased blood supply.
 Cold compress- Ice is used to reduce the inflammation in painful conditions such arthritis. Cold compress needs to be timed properly as over exposure can harm further.
 Manual manipulation- Physical therapists use their hands to massage& stretch joints & their surrounding muscles to help strengthen & correct any dysfunction.
 Ultrasound therapy- Ultrasound helps in increasing blood circulation &reduces inflammation, leading to local healing.
 Electrical stimulation- Electrodes are placed on the affected area, which in turn help reduce pain & muscle spasms
 Laser Therapy: It is a therapeutic modality which is used for tissue healing and pain relief
 Hydrotherapy

As is with any course of treatment, the type of physiotherapy depends on the patient. If the patient is suffering from unbearable pain, the physiotherapist may start him/her off on hot fomentation, cold compress, USG therapy and/or electrical stimulation. If the patient can exercise without causing pain/discomfort, then manual manipulation may be prescribed. 

Nerve pain is due to a pinched nerve or damage to the nerve. It is important to focus on the nerve as well as the muscles around the concerned area.

To reduce the pain, use hot fomentation. Place a hot water bottle or electric belt on the affected area for 15-20 minutes to relax the muscles and promote healing.

Stretching & strengthening exercises of the affected muscle to help reduce the nerve pain.
Few nerve mobilization techniques done by a physiotherapist help in relieving nerve related pain. 
 

The right candidates for physiotherapy are:
 Patients who do not want to undergo surgery to treat their condition
 Post-surgery patients
 Patients with mobility dysfunction, chronic pain and/or diseases that reduce quality of life such as spinal stenosis, Parkinson’s, strokes
 Anyone who has been recently injured
 Immobilized patients   
 

When a person suffers from the stroke, they may suffer from neurological deficits ranging from loss of sensation in the extremities to paralysis. Physiotherapy helps build up strength& prevent wasting away of the muscles. Early mobilization is important when treating a stroke patient as it leads to better outcomes.
The goals of physiotherapy are to maximize the functionality of the patient, reduce impairments and prevent any complication. Strength training and stretching are important in a post-stroke patient. Every stroke patient is different thus there is a need for evidence-based interventions for the patient, noting down the response to each therapy. While some patients may do well in hydrotherapy, some prefer machine exercises. Repetitive movements are a mainstay of the treatment, teaching the patient to practice the movements several times a day. 
 

Depending on the cause of facial palsy and the extent of the paralysis, physiotherapy can help correct it, as an adjuvant to medical treatment. At physiotherapy session, a patient with facial palsy undergoes muscle stimulation, is taught how to massage their face properly, relearn facial movements, stretches that relax the muscles and ways by which they can reduce involuntary facial movements. 

Frozen shoulder is pain, stiffness and limited range of movement of your shoulder due to an injury or overuse of the shoulder. It is common in women between 40-60 years of age.

Proper stretching is the mainstay of physiotherapeutic treatment. Make sure you warm up your shoulder before stretching (10 – 15 minutes prior). The aim is to bring maximum tension with no pain.

There are different stretches one can do such as the Pendulum stretch. Relax your shoulders and lean over the edge of a table. Let your affected arm loose so it feels like it is hanging offwith the unaffected arm supporting your weight. Make a small, circular motion while keeping the arm hung. Repeat these motions 10 times a day.

Another good stretch is the Finger Walk stretch. Face a wall a little less than an arm’s length away. Reach out to the wall with your affected arm and place the index & middle finger at the level of your waist. Slowly, start “walking” up the wall with your fingers, as high as you can without causing pain. Bring the hand back down slowly. Repeat 10 – 20 times a day.  
 

Pregnant women often complain of backache, due to increase of girth around the abdomen. A few muscle-strengthening exercises might help. It is important not only to strengthen the back but the abdominal, buttock, pelvic floor & thigh muscles as well.
Arm & Leg Raises: Kneel on the floor on all fours, with the distance between both hands & both legs roughly the distance from shoulder to shoulder. Raise one leg, tilting your pelvis to give you more balance. Once you feel you are stable, slowly raise the opposite hand. Hold for 10 seconds. Bring them both down together. Repeat on opposite side. Do 10 repetitions each day, slowly increasing the number.
Cat Position: Kneel on the floor on all fours, with your arms straight, directly under the shoulders. Take a deep breath and arch your back upwards, your chin resting on your chest. Stretch as much as you can. Exhale and flatten the arch, with your head rising and chest puffed out, stretching as back as you can. Once you are comfortable in this position, slowly shift your weight on to your arms, leaning as forward as you can. Repeat this motion 10 times a day
Pelvic Tilt on the wall: Stand straight against the wall, your legs shoulder-width apart. Let your hands rest on the side of your body. Feel the gap between your lower back and the wall. Once you’ve felt it, remove your hand and press your lower back against the wall, eliminating the space. Hold this for 10 seconds. Get back to your starting position. Repeat 15 times a day.  
 

There are certain exercises that overlap between physiotherapy and yoga, clearly showing that while they are different in their ideologies, they are similar in different aspects.

Physiotherapy is a rehabilitation program that concerns itself with only one specific problem area at a time; whereas yoga has a more holistic approach where the spiritual and mental health is as important as the physical health.

What unites them is the emphasis on slow movements, with no jerks, focusing on increasing blood circulation and increasing tensile strength. It is about the reaching maximum tension without pain.  
 

Strengthening of the muscles around the hip joint & increasing flexibility are the two ways to reduce hip pain.
Gluteal Tuck: Lie flat on the floor, with your knees drawn and your feet firmly down. Squeeze your buttocks and hold for 10 seconds. Slowly release the buttocks. Repeat 30 times a day.
Bridge: Lie flat on your back on the floor, with your knees drawn and your feet firmly planted down. Increase the distance between both the legs until they are about half an arm’s length away. Putting your weight on your shoulders, slowly raise your buttock of the ground, using your gluteal muscle, quadriceps and abdominal muscles. Hold for 5 seconds, followed by slowly lowering it to the ground.  
 

The number of physiotherapy sessions depends on the type of condition & the health status of the patient. In most cases, a minimum of 10 sessions are strongly advised.

Running is a high-intensity cardiovascular exercise that leads to tightening of the muscles. Pre & Post run stretches are strongly advised to keep the muscle supple and the tendons lax.
Hamstring Stretch: Stand straight and bend one knee backward, holding the toes behind your back with the corresponding arm. Press the leg further into your back, using your other hand to find some support if needed. Repeat the same for the other leg.

Calves Stretch: Stand straight and stretch one leg forward, with the heel on the floor and toes pointing upward. Bend forward and hold the toes, pushing them towards the shin. Repeat the same for the other leg. If you do not want to bend forward, find a surface where you can keep one leg at waist level. Turn your body 90 degrees, and bend sideways from the waist to hold the toes and push to the shin.
Lunge Stretch: Stand with one leg in front and one leg at the back. Bend your front leg to 90 degrees, stretching the back leg as far as possible, to maximum tension. Slowly, shift your weight on to the forward leg, with your arms by your side or resting on the front thigh. Slowly come back to standing straight and repeat for other leg.  
 

Posture while sitting, the vertebral support of the chair & placement of the computer on the desk contribute to workplace neck pain. Apart from rectifying this, there are a few exercises one can do to strengthen the neck:

Side to Side: Stand straight with your arms loosely placed in front. Turn your neck slowly to one side, rolling it to the other side, dipping your chin to your chest in the process. Repeat this movement 30 times.
Shoulder shrug: Stand straight, with your shoulders relaxed. Slowly, raise both shoulders together, like a shrugging gesture, to maximum tension and lower them back to starting position. Repeat 20 times
Tilt to Side: Stand straight, with your shoulders relaxed. Tilt your head slowly towards one side, the corresponding arm gently pushing it down further. Keep for 10 – 20 seconds, repeat on the other side. Practice this exercise 8 – 10 times a day.  
 

Arthritis is a painful disorder which leads to inflammation of joints (Especially weight bearing joints).

A physical therapist aims at reducing the pain and stiffness that is associated with arthritis by using hot and cold treatments. They will explain the importance of posture and how to make sure you are standing correctly. You will be advised about braces, splints and shoes you should be using to maintain a good posture. If you are using a walking aid, such as a cane or a walker, you will be taught how to use them properly.

Manual manipulations, mobilizations, stretching and strengthening exercises are done to reduce the pressure on the joints by focusing on the surrounding group of muscles.  
 

There are several conditions in gynecology that may require physiotherapy such as
 Pelvic Pain: Physiotherapy helps in strengthening pelvic floor which helps reduce the pain
 Dyspareunia: Painful sexual intercourse can be treated by strengthening the pelvic floor
 Uterine prolapse: Kegel exercise is taught to patients of uterine prolapse to retract the protruded organ and strengthen the pelvic floor
 Stress urinary incontinence: When we cough or sneeze, we may pass a small amount of urine. This is known as stress incontinence. Physiotherapeutic exercises help in strengthening the pelvic floor that leads to a more controlled bladder.  
 

A regular physiotherapy session lasts 45 min to 1 hour.

NOTE: Any of the above stated exercises are not recommended without the prescription and advice from a physiotherapist