As a physical therapist, I often deal with people who have more than one problem. Sorting out the top priorities is my prime concern.

Today’s norm requires thinking multi-dimensionally, rather than in a linear fashion.  We can’t think merely, “Do this exercise and your ankle will feel better.” We’re starting to look at the fact that swelling can best be treated by opening up the lymph flow, affecting ankle movement, balance and strength.

Our priority becomes determining which techniques give us the most benefits in the least amount of time. Depending on the problem, certain techniques are more efficient and effective.

I’m sure it won’t be long before someone comes up with a computer program to do most of the thinking, but I don’t believe there will ever be a substitute for the human touch.

Lately, I have noticed an increasing number of patients having multiple problems. They not only have a problem with the muscles and the joints, but also often display systemic problems, ultimately slowing the healing process and/or their progress with a rehabilitation program.

Some have digestive disorders that interfere with healing since they are not getting the proper nutrients absorbed into their bodies. Some cannot sleep, making it harder for the body to heal. And others have a chronic systemic problem, sapping their energy, making it difficult to add exercise to their daily routine for muscle strengthening, since merely doing normal activities of daily living exhausts them.

We need to find more efficient and effective treatment methods. Sometimes this includes helping people sleep better or improving their nutrition to maximize the healing process.

Looking at a person in a simple one-dimensional manner just isn’t enough. The health-care system 30 years ago separated out the various systems and established “specialists.” There were lung specialists, heart specialists, liver specialists, etc. These still exist today, but insurance companies have made “generalists” more important as the front-line manager of a person’s health care.

Today we see the person as a whole integrated system rather than a collection of pieces. Likewise, in physical therapy, the approach has broadened to look at the person from a “system” approach. In the past, physical therapists have been relegated to screening the muscle system and the joint system. Now we also look at the nervous system, the connective tissue system and the ligament system.

We examine the connective tissue system as it relates to the organs, and the muscular system as it relates to the vascular system and the lymphatic system. Physical therapists  understand how the supportive tissues influence the immune system, which is critical for the health of the individual.

Many of these techniques seek to stimulate the person’s own healing process in a gentle manner, so as to cause no further damage. Unfortunately, many medical procedures and treatment techniques do cause unintentional damage while attempting to promote healing.

Take medications, for example. Numerous side effects from medicines indicate destructive versus helpful effects. An unwanted side effect from surgery is scar tissue. A detrimental result from exercise can be increased pain. In looking for remedies for health problems, the solution should contain a multi-dimensional approach including all of the various systems for an overall maximum effect.

Unfortunately, taking one magic pill just doesn’t exist today. Perhaps it never did exist, and we finally see the situation much more realistically.

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Sheila Yonemoto, P.T., has been a physical therapist for over 30 years, specializing in Integrative Manual Therapy utilizing a holistic approach. She can be reached at Yonemoto Physical Therapy, 55 S. Raymond Ave, Suite 100, Alhambra, CA  91801. Call 626 576 0591 for a FREE consultation, or visit for more information. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.

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