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Physical therapy is integral part Of the health
care system today nationally and
internationally but most part of the world it
is not yet a developed profession but a
cluster of some modalities and manual
skills. Internationally physical therapy is
now considered to be independent
profession declared by the world
confederation for physical therapy (WCPT)
and WHO. In most of the developed
countries today patients have fully or
partially direct access to physical therapy
services. It is also very important to know
the education level or entry level degree
program in physical therapy, which is a 17
years of schooling approved by HE and the
curriculum comprises of extensively basic
science, medical and clinical sciences so the
physical therapist today has the capabilities
to assess and treat movement dysfunctions
either due to diseases, injuries, ageing
process ornatural disaster:
The efficacy of physical thera py
interventions has been proved in many
areas with limitations but in orthopedic
Medicine the role of physical therapy is very
crucial. In physical therapy the main focus is
on biomechanics and ergonomics, e.g. how
different movements can be initiated by
skeletal muscles and bones around different
axisand planes while the stability and
coordination will be ensured because any
loss Of movement or dewiation flom its
physiological axis will result in the loss Of
Dr. Asghar Khan
Director\Associate Professor
Riphah College of Rehabilitation Sciences (RCRS)
Riphah International Unversity Islamabad
functional activ ities.
In orthopedic conditions; if it is related to
joint mobility, fracture or muscular
problems the role of physical therapy
intervention is very important. If the
problem is Of a physical nature only physical
intervention can be helpful'e.g. in total knee
or hip orthoplasty the patient can only take
ad vantage of the artificial joint when he/ she
get proper physical therapy intervention
before and after surgery because the
surgeon will replace the joint but it is the
physical therapist job to make it functional,
so the success of all orthopedic surgeries
depends on the good physical therapy care.
A physical therapist has been trained to
mobilize the joints without causing any
inflamma tory reaction.e.g in frozen
shoulder(adhesive capsulitis) most of the
time the patient has been advised to do some
specific exercise to get range but those
exercise could make the shoulder worst
because breaking the adhesions by
stretching can cause the inflammatory
reaction again and again whichresult in new
scar formation which further restrict the
mobility Of the joint but when it is mobilized
by the physical therapist manually most of
the time it does not cause any inflammatory
reaction because he/ she applies accurately
determined and specifically directed force
towords the joint in order to improve
mobility. He/she is also aware Of the
concave & convex role of mobilization,
biomechanics, and the resting position of the
joint. So after few sessions the patient gains
mobility in the joint and able to perform
functional activities.
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Skeletal muscle loses strength in traumatic
injuries or surgeries, which is most Of the
times resulting in functional loss, so
strengthening of weak muscle is notpossible
without physical therapy interventions.
Physical therapists are trained to write
exercise prescription for individual muscle
endurance and strength and also able to
impleme n t the treatment
plan. Muscoloskletel pain is another major
problem in orthopedic medicine which can
cause severely functional loss in the human
body,e.g; back pain or any joint pain due to
degenerative changes result in muscle
weakness and decreased range of motion
which could be the main reason for
functional loss, again that can be restored
with the help of physical therapy
intervention by eliminating the pain with
manual therapy. According to Lederman
"Manual Therapy, in its many forms, is
probably the major method, after
medication, for the relief of musculoskeletal
pain". (Lederman E. Second edition-2005)
Physical therapy intervention can also play
a significant role in the correction of
musculoskeletal deformities through
stretching and strengthening and by the use
Of corrective devices of different kinds.e.g;
scoliosis can be corrected through stretching
Of the muscles on the concavity and
strengthening on the convexity,
alsoThoraco- Lumbo-Sacral Orthosis (TLSO)
can be helpful for the correction of the spine.
Torticollis, also known as wry neck is any
other condition can be treated successfully
with physical therapy intervention. After
fracture immobilization cause significant
decrease in range Of motion and also causes
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disuse muscle atrophy which ultimately
cause severe loss of function. This problem
can be treated to restore function only with
physical therapy intervention.
so there is a very close relationship between
orthopedic Medicine and physical therapy.
The physical therapist should be part Of the
orthopedic team. In most of orthopedic
cases physical therapy intervention is
necessary for the successful outcome and
when the physical therapy intervention is
ignored in many cases very serious
complications result which cause serious
problems to the patients. so it is suggested
that in all orthopedic unit this protocol has to
be in place that every patient in the
orthopedic unit has to be evaluated by
physical therapists to avoid complications
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of any procedure or surgeries and the
maximum function and mobility of the
patient has to be resorted. It is evident from
the literature that early mobilization can
decrease hospital stay and also decreases the
chance of complications to occur after any
procedure or surgery.
Asghar Khan. (2013) The Role of Physical Therapy in Orthopedic Medicine, Journal of Islamic International Medical College, Volume-8, Issue-1.
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