Physical therapy is a broad sphere of medical practice that encompasses many needs and scenarios. Simply put, a physical therapist helps patients achieve, maintain, or restore maximum movement and functional ability.

The need for physical therapy can arise from many circumstances. The old and infirm need assistance in maintaining movement. The injured need therapy to recover movement. Those born with a physical or neurological handicap need therapy to develop movement.

A few of the conditions which a physical therapist may help with include: back and neck pain, spinal and joint conditions such as arthritis, biomechanical problems and muscular control, problems affecting children such as cerebral palsy and spina bifida, heart and lung conditions such as chronic obstructive pulmonary disease and pneumonia, sport-related injuries, stress incontinence, and neurological conditions such as stroke and multiple sclerosis.

Physical therapists usually specialize in a specific field, such as pediatrics, geriatrics, sports medicine, orthopedics or neurology. Now considered a doctoring profession, physical therapists are certified experts, which requires a master’s degree and a curriculum in the basic sciences. Degree programs in physical therapy involve more advanced courses in biomechanics, human growth and development, and manifestations of disease. Their level of medical training is a surprise to some people, because to watch a physical therapist work, you might at first mistake them for a coach or a counselor.

In fact, coaching and counseling are a great deal of what physical therapy is all about. Physical therapists take a very active role with their patients, guiding them through exercises designed to help build the patient’s mobility. They may be working on the track or in the gym with a sports injury case, in a hospital coaxing a stroke survivor to take their first few steps with a walker, or in a swimming pool using the water’s buoyancy to help a recovering accident victim with a fractured pelvis learn to walk again.

An Ancient Art

Physical therapy as a profession goes all the way back to ancient China, where the healing powers of massage were first recognized. Physical therapists came into their first mass use during World War II, when soldiers coming home with spinal injuries created new challenges for the profession. Orthopedic hospitals and chest clinics for veterans soon sprang up, with physical therapists running the show.

In many countries, the profession of physical therapy has grown to become one of the largest allied-health professions, behind only medicine and nursing in the number of graduating healthcare students.

Working with Disabled Children

Children may be born with mobility problems for many reasons, some of which can be improved or totally cured with physical therapy. A baby with cerebral palsy has a very good chance of being able to partially recover by the time of adulthood. This is due to the brain’s ability to patch itself by growing new neurons. But in order for those neurons to form in the first place, the child must receive the right type of stimulus.

They say that riding a bike is something that, once you learn how, you never forget. This actually applies to all mobile activities. Anything from crawling to surfing is a learned set of muscular coordination reflexes, and to develop them, we have to practice. Once the brain has learned how to guide the body through a set of motions, new neuron pathways are formed in the brain to retain the learned behavior. The act of learning an activity is actually one of providing physical stimulation to the body, which in turn is used by the brain as raw material to build a ‘muscle memory’ of the behavior.

Tools of the Trade

A physical therapist working with a disabled child who cannot crawl, for instance, may start by placing the child on his belly on a soft inflated ball. With just his feet and hands touching the floor, and without the necessity to support the body’s entire weight on the limbs yet, the child can move himself around on the ball by pushing against the floor with his hands and feet. Later, the ball might be replaced with a padded board on wheels. Just like training wheels on a bike, the motion is practiced in gradual steps until the child can both develop the muscle tone and learn the gross motor skills necessary to carry out the task.

Similarly, an older patient with a mobility problem due to an injury or stroke might need to teach her body how to walk again. By suspending her body in a shallow pool with a floatation vest on, she can walk around on the surface of the pool bottom with her body’s weight mostly carried by the water. In this way, her legs and feet can rebuild muscle tone and her brain can learn to remap those neurons that may have been damaged or forgotten.

Do-It-Yourself Therapies

Tai Chi, a ‘soft’ Chinese martial art, has made some popular gains in senior patrons of physical therapists. The gentle, graceful movements and slow pacing are a deliberate effort to force the body and mind to focus on mobility. As opposed to the ‘training wheels’ approach, this is more of a ‘slow and steady’ model, but even though the Tai Chi class may look like slow-motion aerobics, the benefits are staggering.

Researchers have found that long-term Tai Chi practice has favorable effects on the skills of balance, control, flexibility and cardiovascular fitness, and helps reduce the risk of falls among the elderly. The studies also reported reduced pain, stress and anxiety in healthy subjects who took Tai Chi. Other studies have confirmed improved cardiovascular and respiratory function in healthy subjects, along with those who had undergone coronary artery-bypass surgery.

Pilates is an exercise regimen with very different roots in Europe and America instead of the Far East, but with similar goals in mind. The inventor of this exercise named it "Contrology", which refers to the way the method encourages the use of the mind to control the muscles. It is an exercise program that focuses on the core postural muscles that help keep the body balanced and are essential to providing support for the delicate muscles of the spine. In particular, Pilates teaches an awareness of breath and alignment of the spine, and strengthens the deep torso muscles which are important to help alleviate and prevent back pain.

There’s more to physical therapy than meets the eye. Indeed, the benefit is mostly applied through the mind, although physical therapists speak as if the body almost has a mind of its own, which the brain merely oversees. In a way, a physical therapist can be seen as a ‘brain programmer’ or reprogrammer! No matter what our level of fitness or physical condition, we’re almost bound to require the services of a physical therapist at one point or another in our lives.