The Science of Movement – An Interview

By Priya Prasad

“What I understand from my career of 14 years and one lakh patients is that movement is very important for everyone, movement is life.”

In India, there is little awareness of the benefits of physiotherapy. In developed countries, patients are first offered physiotherapy before opting for any surgical procedure. Dr C Anand Jyothi, owner of Sri Sugam Physiotherapy Institute tells me why this is so. An inspired and committed individual, Dr Jyothi recounts his inspirational journey into the field of physiotherapy.

What is your specialisation?

I’m Anand Jyothi and I’m a physiotherapist specialised in musco-skeletal, manipulative and sports physiotherapy. I’m the chairman of Sri Sugam Physiotherapy Institute since 1999.

What kind of work do you do here?

I’m a specialist, a physiotherapist. As we all know, physiotherapy is a movement science so we deal with movement and posture. We deal with all types of people, young and old who have movement dysfunction; for example, those who are not able to walk, stand, bend or perform any daily activities.

We also provide prevention treatment for the sporting group of people. Sports persons require more physical intensity, physical strength and stability. Different sports need different types of stability. Let’s say, if you see a basketball player, the stability is different from a golfer and a football player; they always move on one leg to kick the ball; a tennis player moves on both legs but uses one limb, the right hand, more often. We deal with movement analysis and biochemical evaluation for sporting people. We correct their body mechanics. For example, certain elite athletes have some difficulty with the back hand stroke, so we’ll do a video analysis and then give a sports-specific exercise to improve that particular technique, not just general training.

Other than that, we provide physiotherapy services pre- and post-surgery. Generally, in India, the awareness for physiotherapy pre- and post-surgery is very less. People think that after surgery the treatment is over. But in Australia, where I studied my post graduation, the rehabilitation after surgery, even for caesarean pregnancies, joint replacement or spinal surgery, will be around six months to one year, where we will take patients through different phases of rehabilitation, from non-weight bearing and weight bearing exercises, strength training , stability training and functional training. We follow this method at Sri Sugam.

The clinical diagnosis is key to physiotherapy practice. For example, consider somebody with neck pain, they may have a different muscle problem or sometimes a postural [problem], they may have a booking chin and rounded shoulder. We don’t just treat the pain, we understand which structure is causing the pain, it may be a muscle or the area around the neck or it may be a nerve root. Sometimes contributing factors like pillows can cause the neck pain. This diagnosis is quite different from a medical diagnosis or what they do in an investigative procedure such as MRI scan and X-ray.

What was your inspiration for setting up this clinic?

Physiotherapy has been a childhood dream. I’m from Vellore and I’ve been inspired by my school teachers who have helped the community. When I was in school, every three to four months, the teachers would take us to a rehabilitation centre on Sundays, like the cerebral palsy home.

During my undergraduate years, I realised that we treat patients every day. When I used to work at the government hospital, I would see at least 70–100 patients per day. But at the end of the day, to be honest, I didn’t know what I was doing. We know how to treat the patients but if they would ask me a question, I wouldn’t know how to answer them. During my final undergraduate year, I realised I needed to expand my knowledge. I heard about an extension Master’s degree programme in Australia.

In India, physiotherapy is not a very popular profession. It is the case in present times as well as 13 years ago.  When I went to Australia, my first class was on clinical reasoning. When I was an undergraduate, I never reasoned. If the patient has knee pain, then I would prescribe four exercises, similarly for other aches and pains; we have a recipe of treatment. But in my first class on clinical reasoning, I learned that we must think first before touching the patient. We would talk with the patient for at least half an hour to 45 minutes or even one hour.

What I understand from my career of 14 years and one lakh patients is that movement is very important for everyone, movement is life. That’s why our caption at Sri Sugam Physiotherapy is ‘Keep Moving.’ We kept it very simple. When people lose movement, they become dependent and definitely lose their morale, their confident level and they become sick.

Are your services restricted only to the middle class and elite sections of society?

From the health point of view, people from all walks of life come here. We treat car drivers, gardeners, IAS and IPS officers. When it comes to pain it’s not a matter of affordability. Relief is of utmost importance. In Sri Sugam, as a matter of policy, we have a CSR activity for poor people. We sometimes charge less or at times, give treatment free of cost. We do this unofficially.

We support a lot of schools. I provide honorary, i.e., free services, at the Paralympics Association of which I am a part. We also have an association where we provide a bit of sponsorship and some people themselves become sponsors.

For 14 years, from 1999, we have worked only through word of mouth. Right now we have crossed more than 1, 25,000 patients which is huge in rehabilitation.

Not just another library

By Priya Prasad

As you drive down Kotturpuram, it is difficult to ignore the massive behemoth that will loom up. What is most striking about the structure is the modern design. You do not see such structures in India; it seems to have been magically transported from New York or London or Tokyo.

At first glance, you would think it’s another monument dedicated to some great Tamilian personality or politician; it even seems to look like the place where government secrets are housed.

The glass edifice, clinically clean green lawns, open air amphitheatre resembling a Roman theatre, a cafe and eight floors of a plethora of books, magazines and periodicals—it’s a bibliophile’s wildest fantasy come alive!

Architecture and Facilities

There’s much to be said about the architecture of the library. Designed by architect, C R Narayan Rao, and constructed by East Coast Construction and Industries (ECCI), each section of the library is designed to suit the various categories of books housed there. For instance, as you enter the children’s section, you are greeted with a cosy atmosphere, where colourful small chairs and children’s books of different shapes, sizes and lengths pepper the area. A large artificial tree dominates the centre of the room with colourful table and chairs surrounding it; this is the children’s fun activity area. Outside, in the balcony is a little play area for the little ones. The reading areas in every section are located near windows allowing in just the right amount of heat.

The children’s section at Anna Centenary Library. Photo credit: http://www.aclphoto.blogspot.in

“What I like most about the library is the infrastructure. For a public library, it is very large. Every library is unique but this one is different altogether. I have never seen any library have so many floors,” says Kavitha (name changed), an employee at the library. “Of its many facilities, the library allows the public to bring their own books. This is not the case in any other library, even in the previous place [Connemara Public Library] where I worked,” she adds.

This uniqueness itself is what attracts the 1,000–1,500-odd visitors to peruse the services of the library. “Researchers, students, people appearing for competitive exams as well as people who read the newspapers regularly come here. A lot of engineering students from IIT and Anna University visit the library because it has many of the expensive books that they need to refer to,” says S Karthikeyan, Library Information Officer.

“This is my second home. I use the competitive examination section and the ‘own-book’ reading section,” says Ramakrishnan, an IAS aspirant who is a regular at the library. He says that the library management have designated a special time slot for civil service aspirants, from 8am to 9pm, which is a “gracious attempt by the management people.”

Karthikeyan says that each section has been structured bearing in mind ease of access for the public. For example, being the most visited area, the newspaper and periodicals section is housed on the first floor so that even the old and differently abled can easily access it.

He further states that the library has an exclusive Tamil section with about 24,000 books. “We also have a Braille section where there are about 1,000 registered users from Tamil Nadu as well as from outside the state,” he says.

The Controversy

Established in 2010 by former Chief Minister M. Karunanidhi, the library was constructed to commemorate the 100^th birth anniversary of C N Annadurai. However, in 2011, when Jayalalithaa came to power, she ordered the 230 crore library building to be shifted to Nungambakkam and a paediatric hospital to be constructed in its place (Jayalalithaa’s decision to shift Anna Centenary Library stayed by court, Times of India, November 4, 2011). A PIL was subsequently filed in the Madras High Court and ever since then the issue has been in limbo. Karthikeyan says that the pending court case has caused a number of problems for the library—the staff are not confirmed; books, periodicals and other publications are not renewed; there is no membership so there is no borrowing or lending. “Earlier, before the problem with the court, we used to have many children’s programmes,” says Kavitha.

However, despite this, the library continues to draw its usual share of visitors. Employees too are satisfied. “There is no membership here, despite that the atmosphere here is different. It is well maintained. The housekeeping staff work all the time to ensure its upkeep,” says Kavitha.

There are various ways the library can generate revenue. “We are going to shift some of the services online,” states Karthikeyan. Perhaps, by creating online membership, the library can open its services to people outside Chennai. Moreover, an amphitheatre, a lecture hall for events and an auditorium are some of the means by which the management is ensuring the library is up and running. Last year, the state government began renting out the auditorium for wedding receptions and parties (Anna Library auditorium turns into marriage hall, Times of India, July 2, 2012)

A Dedicated Work Force

Despite its problems, the library is efficiently managed by a management team of professionals. All employees have a minimum qualification of a Master’s in Library Science. There is a process through which the employees are chosen. First, applicants have to appear for an exam organised by the Teacher’s Recruitment Board. Once that is cleared, candidates are shortlisted for interviews. Many people apply, few are chosen. “That is how I got recruited. I have been working here since 2010 and I am very satisfied with the working conditions here,” says Kavitha.

“We cannot find this kind of infrastructure in other cities. I have been to various districts, Coimbatore, Delhi; I think it is one of the finest libraries,” says Ramakrishnan.

Being the largest library in India with state-of-the-art facilities, it would indeed be a tragedy if the library were to be shifted elsewhere.

From Local to Hyperlocal—The Water Conundrum

It’s been almost two weeks since the students at the Asian College of Journalism have settled down and they are already witnessing first-hand the infamous water shortage problem of Chennai. “It’s not only ACJ but Chennai has a water problem as well. It does get difficult for us to store water in our buckets and use it productively. Also, the water has a weird muddy colour to it,” says Oindrilla, a student at ACJ. She further states that the water is rather salty and causes a lot of throat problems for many. Besides this, students have also reported being late for class because of no water flow in the mornings.

The water shortage problem also poses a major inconvenience to those with the six-room occupancy. “The water doesn’t start till 7 or 8 am, and there are six of us in one room so it gets very inconvenient,” mentions Harsh.

However, this isn’t a one-sided issue of negligence on the part of the management. Some students do feel that it is up to them to take responsibility to conserve and utilise water judiciously. “It’s actually up to us to save water because there are a lot of people who leave the taps open when the water is not running and when the water comes on again, the whole tank empties,” says Oindrilla.

ACJ is equipped with a motor that supplies water throughout the college as well as two to three sams or storage tanks. The administration states that water scarcity is bound to occur—there are nearly 150 students residing in the hostel and the faculty comes to the college between 9 and 5, so water usage is at its peak during the working hours. Regarding students leaving the taps open, the administration says, “We haven’t put up any notice so we tell students to pass on the message to keep the taps closed when they leave their bathrooms.”

This issue reflects the wider water problem that Chennai faces. In June, there were media reports of a reduction in the groundwater table. “There is water shortage mostly in the months of summer when the metro water system is not as effective as you’d want it to be, but people have circumvented it by installing bore wells wherein they harvest the ground water. But that again leads to depleting water table levels,” says Zahaan a student at ACJ and a local resident.

Eventually, it comes down to how we conserve water and the environment at large, and this effort has to stem from individuals, governments and institutions.

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