Unlike in Europe and the United States where rehabilitation has long been widely practiced, people in China still lack a clear recognition of rehabilitation and often confuse it with Chinese tuina massage. Dr. Zhu Guomiao, the Founder of Spinecare, explains the true meaning of rehabilitation
Rehabilitation includes “physiotherapy” and “sports rehabilitation”. Physiotherapy is often associated with concepts like medium-frequency or electrical stimulation. In essence, it is a technical method. Sport rehabilitation refers to motor system rehabilitation of human body.
The human body has eight systems: cardiovascular system, cerebrovascular system, endocrine system, digestive system, respiratory system and so on. So what is the motor system? It is related to one’s muscles and bones. Therefore, the rehabilitation of the motor system is actually the rehabilitation of the muscle and bone system.
We often hear about neural rehabilitation, cardiopulmonary rehabilitation, children’s rehabilitation, and even psychological rehabilitation. Neural rehabilitation is mainly aimed at people suffering from stroke and cerebrovascular diseases while cardiopulmonary rehabilitation is usually delivered to patients with respiratory tract problems, lung tumor and heart disease. However, the target of sport rehabilitation is often young people since they are more likely to have sport injuries.
Rehabilitation complements medical procedures
The concept of rehabilitation entered China just several years ago. In Europe and U.S., the proportion of “medical treatment” and “rehabilitation” is 5:5 or even 3:7. The surgery takes up only 20%-30% while the large part of healing is entrusted to rehabilitation. Western doctors believe that every medical treatment should be followed by rehabilitation.
In China, however, due to economic limitations and huge numbers of patients, the goal of medical procedures is to “save lives”. For instance, when someone has a stroke in the rural areas, the doctor’s mission is just to let them not die. The person may be bedridden for several decades, unable to speak, walk, eat or tend his own basic physical needs, until death. If fortunate enough, his families would tend him carefully and deliver massages to help him alleviate the pain. Anyway, this bedridden period is extremely suffering to him both physically and mentally.
When it comes to rehabilitation, after the first aid is delivered to the stroke patient, the doctor should furtherly help the patient restore the ability to tend his own needs and back to normal life. It means, the doctor not only saves you from death, but will also enable you to normally participate in the social activities and enjoy your family life as before. This is the meaning and value of rehabilitation.
The concept of rehabilitation became popular in Europe and U.S after the First World War and Second World War. Many soldiers, though their lives were spared, lost arms and legs in the battle. So how can we help them restore their dignity and go back to normal life? The answer is rehabilitation.
Why does rehabilitation develop so slowly in China? First, the concept didn’t enter China until recent years. Moreover, we have our TCM. TCM has done part of rehabilitation work. However, it mixes up treating diseases and rehabilitation. Acupuncture, cupping, guasha are ways both to treat the disease and to help the patients rehabilitate. Through acupuncture and tuina massage, a patient with a stroke may be able to walk gradually. But from another aspect, TCM narrows people’s vision. As many Chinese may say: we have tuina massage which is much better than your ways of rehabilitation. Such thoughts hinder the development of rehabilitation in China. They don’t sense any difference between TCM and rehabilitation. But there is a big difference, as big as that of Chinese medicine and Western medicine.
TCM emphasizes skills. People often say: “I am skillful at tuina massage or acupuncture.” As a result, we see department of acupuncture, department of tuina, department of guasha. All the departments are named after skills. Of course TCM doctors are really skillful, yet they lack a deep study and understanding of human body structure.
In Western medicine, there are cardiovascular department, brain surgery department, digestive department, all of which are named after body structure. So Western doctors study very well the structure of the human body and trust in modern science. Of course Western medicine also has its shortcomings in certain aspects.
So we can see the different focus of TCM and Western medicine. The former focuses on skills and the latter on body structure.
The problem of focusing on skills is that you will always be limited by the development of technology. When you fail to catch up with the latest technology, it’s impossible for your services to be renewed and personalized. Your diagnosis to every pain will always be: qi stagnation and blood stasis.
The advantage for studying body structure is that you will have an endless mine to probe into from macroscopic to microscopic areas. Meanwhile, you have a clear direction how you should renew your technology for you now see problems more concretely from the perspective of bones, blood, organs, tissues and more.
I believe Western medicine and TCM are complementary. Regarding TCM, it’s easy for someone to have some basic knowledge and skills of TCM in a short time yet not so easy to have continual development in the long run because it requires the doctor to have the ability to comprehend by intuition. But it’s nearly impossible for a young person without sufficient clinical, social and life experience to possess such ability. Moreover, young peoples’ lifestyle today is totally different from the past. There is a large gap for them to deeply understand the wisdom of TCM, let alone becoming TCM masters. So a good TCM doctor is hard to duplicate.
Concerning Western medicine and rehabilitation, it is not so easy at first because you need to learn many things like anatomy, pathology, physiology and more. However, there is a very clear path for you to develop and improve continually. Also, you are able to clearly tell the reasons for the problems of the body and find corresponding solutions.
Young people increasingly prefer rehabilitation
Though it still needs time for rehabilitation to be widely recognized in China, we see more and more young Chinese sharing a very similar lifestyle with their Western counterparts. Doing sports and having a diet of high protein and low carbon has become their daily routine. They are so keen on shaping the body and toning the muscles. That’s why I said it’s more probable for them to have sport injuries.
Meanwhile, they are super busy in their work. So many of them suffer muscle and bone problems resulted from long sitting before computers, bending over a desk for long, staying up late and poor diet. Rehabilitation is a good solution for these sub-health conditions.
As I observe, the 1980s and 1990s generations are very willing to accept the concept of rehabilitation. When I say to them: you have blood stasis or cold-dampness, they feel it’s very abstract and don’t know how to solve the problems at all. On the contrary, they can understand quite well when I tell them what problems they have in their bones or muscles. For example, I can clearly tell them: you have an injury in your trapezius muscle, and I show them the 3D screen image, then I treat their trapezius specifically and they immediately feel the pain alleviated. Of course they embrace such a way of treatment.
Rehabilitation can also be used by children. In today’s competitive society, children are buried with books and need to sit in front of the desk for a long time. Very easily, they can have spinal problems due to poor sitting posture. Many young parents will then take their children to doctors of rehabilitation and consult on how such problems can be solved.
I believe in the next 5 to 10 years, rehabilitation will become very popular in China. More and more Chinese people will accept and embrace rehabilitation.
As a doctor specialized in rehabilitation, I am very glad to see increasingly number of young people are willing to understand and trust rehabilitation. I am also willing to devote more time to promote this concept to the public.
Dr. Zhu Guomiao
Dr. Zhu Guomiao is the Founder of Spinecare and a senior TCM acupuncture and tuina master. He accumulated rich clinical experience when he worked in The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Yunyang Hospital of Integrated Chinese and Western Medicine, and Shuguang Hospital Affiliated to Shanghai University of T.C.M. During his post graduate and PhD study, he has been taught by Prof. Fang Mian, 973 chief scientist and Prof. Yan Juntao, the first tutor of PhD students in the Science of Tuina. Dr. Zhu has published over 500 aca-demic paper and popular science articles, and several books amounting to 3 million Chinese characters.