Dr. T. Abayomi Oshin, the doyen of physiotherapy in Nigeria and the first black African to qualify as a physiotherapist, in this interview with Sade Oguntola, recounts his experience in the profession, why back pain is on the rise and how best to maintain good health. Excerpts:
Bad sitting habit is a reason for back pain in some individuals, how is this so?
Basically, low back pain occurs for various factors. A wrong sitting posture is one. Whether it is to prevent low back pain or maintaining the correct posture by sitting upright, maintaining the curvature of the spine and neck is important. When sitting upright, the lower back should be rested adequately in conformity with the shape of the back bone.
Of course, not every part of the back will touch the chair’s back rest because of the curvature in the neck and lower back. And it cannot be forced to be straight. One can only place, say, a pillow to maintain that curvature.
Nonetheless, back pain can arise from maintaining a wrong posture when lifting a heavy object. It can also be as a result of a strain in the muscles, ligaments or even bones of the back.
Also, individuals with deformities on their back such as those with hunch backs or those arising from wrong posture also can develop back pain.
But just as there could be back pain, so also do neck pains occur. When the neck is not properly supported, neck pain can arise. In fact, a sprain in the neck is one of the reasons why some people wear collar around their neck.
Given that low back pain can result from different conditions, one mode of treatment will not fit all cases.
As a physical therapist, how do you rate Nigerians’ involvement in exercises?
If I can take myself as an example, personally I do series of exercises everyday. As a routine, maybe because I am a physiotherapist, I exercise all my joints lying on the bed and while standing in my room every day before having my bath to maintain the integrity of my muscles so that they will not be weak, flabby or unable to perform their roles.
Is this part of the reason you are still standing tall and straight at age 90?
Well. I do not know. Many people have suggested this. But I do not know. But I always ensure I maintain good posture when walking or standing.
Also as part of my exercise routine, every evening, I walk gently four times round this house. Again this is to maintain the aeration of my lungs; blood and body fluid circulation in a bid to improve the nutrition of my muscles and take waste products away.
Of course, I also encourage people to climb stairs rather than use the elevator. I do it too because it is a part of my daily exercises. In my house, there is a staircase and I cannot count the number of times I climb it in a day.
Maybe I left my glasses upstairs, instead of asking one of my maids to go up and fetch it, I would go up to get it. Visitors, and sometimes my children, think that it is too much for me and even caution me against it. But I always remind them that it is part of my daily routine.
Is the normal day to day activity enough exercise to maintain good health?
Aside the fact that the normal day to day living activities are reducing because of technological advancement, the activities of daily living are never enough to keep healthy. It is always limited to certain parts of the body. For instance, take someone that is washing, such only uses the hands. Therefore to equate house chores to sufficient level of activities to maintain good health is wrong.
How responsive has the Nigerian government been to the plight of people with disability since they form a high percentage of physiotherapy clients?
Not much care is given to people with disability in Nigeria, unlike when I was in the USA or UK, when people with disabilities were 100 per cent cared for. Aside having centres where things were provided for them, they also have people visiting them in their personal homes to assist them with chores they could not do. And that is lacking in Nigeria.
Take homes like Oluyole Chesire Home and School for the Handicap in Ibadan, there is not enough input by the government except by volunteer organisations.
How about the society’s response to their plight?
Many people are not educated enough to know that anybody can become disabled for different reasons– postural defects, paralysis from stroke and motor accidents. Some people end up being wheel chair bound because of a spinal cord injury from road traffic accident.
Also of concern is the fact that, in donated wheel chair, donors never consider that those wheel chairs, clutches and other gadgets persons with disability use should be tailor made for each individual. When donating wheel chairs for kids, very large wheel chairs are given. Like one’s clothing, it should be size and disability specific. The wheel chair a hemiplegic requires, for instance, is different from that for amputees.
Again, there should be centres where people will be thought how to use these gadgets, not only wheel chairs so that their benefits can be maximised.
While active in service, you developed many prosthetics for your clients, what were some of them?
Many years back, we lacked equipment and things that the patient needed and so I started designing gadgets to help to revitalise weak nerves in different conditions like polio. There were appliances for correcting things like injection palsy and even oja palsy.
What is oja palsy?
Oja palsy is a palsy you find in Nigeria when babies are strapped on the back especially of younger persons, who have not developed enough muscles of the back to support the baby. So that the baby will not drop, it is made very tight and this constricts the nerve around the knee, thus preventing impulses going to the muscles and eventually paralysing it over time. Now, if the oja is at the middle of the thigh, there is no problem. But if at the knee area, it can lead to this problem.
If you are to rate physiotherapy care in Nigeria, how accessible is it to the common man?
Well, there is increased awareness on the profession of physiotherapy in the society, unlike in the past. Presently, many teaching hospitals and general hospitals offer physiotherapy care. So, I think that physiotherapy is accessible, but if you are talking about cost, I cannot tell you what the situation is. In my days of practice, treatment was free.
But presently, they must make money to ensure sustainability of the facility. So, they charge for clutches. Even for consumables like bandage, patients must pay.
Your contribution to the practice of physiotherapy
Being the first Black African physiotherapist in 1954, my greatest contribution to physiotherapy is capacity building. Even now, in retirement, Association of Physiotherapy students still come to visit me, wanting to know what physiotherapy was like in our time and at such opportunities I ended up teaching.