It Takes a Village Part 1 – Physiotherapist

It Takes a Village Part 1 – Physiotherapist

18 Jan 2021

For most of us with autoimmune conditions, we head straight to our rheumatologist for any number of symptoms. Many patients do not realize that a trusted rheumatologist is only part of the ideal health care team. From family to specialist practitioners, there are a number of individuals who can help ensure your wellbeing throughout your health care journey. This new series has been developed to help you discover how to build the best support network for your needs. Each month we will delve into a number of specialists you may want to join your health care team.

Physiotherapist

Physical therapy is about more than recovering from a torn ligament or sprain. It’s about restoring movement and strengthening people who are struggling with mobility and independence. Rheumatological physiotherapy is a specific form of physiotherapy aimed at treating a variety of rheumatological conditions. Rheumatological physiotherapists are experienced at assessing and treating the wide variety of symptoms associated with any rheumatological conditions.

Autoimmune diseases like rheumatoid arthritis (RA), multiple sclerosis (MS), and systemic lupus erythematosis (SLE or “Lupus”) can cause muscle weakness, fatigue, and painful, swollen joints. This occurs through chronic inflammation of different tissues, organs and systems in the body simultaneously. The most common medical treatment for autoimmune diseases is either long-term steroids, other disease-modifying drugs like DMARDS, or a combination of drugs from different drug classes. While medical management remains the primary and most effective treatment, options exist to make use of other physicians. In some cases, physical disabilities can occur due to the various symptoms of these diseases. In others, stiffness joints can make everyday tasks seem like climbing a mountain. The physiotherapy used to treat rheumatological conditions depends on the symptoms and severity of the disease.

Physical therapy can go a long way to restore the functional ability lost to the consequences of joint pain, deconditioning, and even neurological symptoms of the disease clients. Patients might be educated on proper biomechanics and work posture to reduce risk of injuries and strains to the musculoskeletal system. Walking aids and assistive devices will be prescribed as required to improve independence and quality of life.

Often patients remark that physiotherapy has been a godsend giving them a more comfortable life. Importantly, a physiotherapist will first do an assessment to determine what level of flexibility and mobility you currently have in order to plan a program to suit your individual needs. Your physiotherapist may sit down with you to discuss your expectations and goals. While this therapy can be highly successful in reducing pain, it is important to begin with realistic expectations in mind. Physiotherapists will also be able to determine your limits and will work to help you gain the most reward possible without creating new discomfort.

This often tends to be a two-way conversation, so that you are actively part of deciding which is the best route for you to go given the information  garnered in your assessment. Exercise is the main component in the rehabilitation of patients and aims at increasing physical capacity, muscle strength, aerobic endurance, cardiovascular fitness and functional abilities, and helps to prevent secondary deconditioning due to reduced activity levels.

Techniques physiotherapists may use:

• Cryotherapy, also known as ice application, is the simplest and oldest way to treat injuries. Ice is believed to control pain by instigating local anesthesia. It also decreases oedema, nerve conduction velocities, cellular metabolism, and local blood flow.
• Splinting and wrapping facilitates the normal healing process of soft tissues. It supports and protects the muscles surrounding an injured or flaring joint and it reduces swelling.
• Your Physio may have a swimming pool allowing you to benefit from participating in hydrotherapy. This allows you to strengthen and tone muscles with resistance without putting too much pressure on the joint.
• Wax therapy allows the physiotherapist to use paraffin wax as one of the most effective ways of applying heat to improve joint mobility by warming the connective tissue. It is mainly used for painful hands and feet and is used by our physiotherapists in conjunction with gentle mobilization techniques and a tailored exercise program.
• Physiotherapists often have specific equipment to assist those with mobility difficulties to still use and strengthen certain muscles.
• Of course, there is also medicinal massage which increases blood circulation, eases knots in muscle and can help you to de-stress (with stress being an important trigger for flares).

What can be achieved from physiotherapy:

• Decreased joint stiffness and expanded range of motion
• Strengthened muscles and more stable joints
• Improved cardiac endurance
• Improved neurological coordination to reduce fall risk
• Reduced stress
• Weight loss
• Improved sleep patterns
• Decreased feelings of depression often associated with disability

Learning these exercises from a professional may also give you the added benefit of taking what you’ve learned and applying it home. Physical therapy can aid in reducing the many effects of autoimmune diseases. Specialized exercises prescribed by a skilled clinician can serve the patient well to counteract deconditioning, fatigue, pain, and dysfunction that can accompany these chronic diseases. A physiotherapist will often set goal-orientated activities as a way for patients to track their progress and realize what they had achieved thus far.

Even in these difficult times, see if your physio will do zoom lessons with you (great a Private lesson!) or go to YouTube to find some simple routines to follow (great no one can see me in Lycra!). Importantly, do not attempt anything on your own that has not been approved by your physiotherapist in your sessions. Pushing yourself further than you should or attempting an exercise you’ve never been shown how to do correctly may aggravate your underlying condition or may cause permanent damage.

The aim of Physiotherapy is to help optimise physical abilities through exercises and to educate and empower patients in self-efficacious long-term management of their chronic conditions.