Day 12 in the Hospital - Reflections on Rehabilitation September 8, 2026 (Tuesday), Reiwa 8

Today is my 12th day in the hospital.

Most of the therapists who work with me at this hospital are occupational therapists (OTs). Because of the therapists' days off and work schedules, I have also had one session with a physical therapist (PT).

As I have been receiving rehabilitation every day, I suddenly began to wonder:

"What exactly is the difference between a physical therapist and an occupational therapist?"

So I did a little research online.

The word "rehabilitation" comes from the Latin words "re," meaning "again," and "habilis," meaning "fit, suitable, or capable." Originally, the word carried the meaning of restoring a person to a human or dignified state, or restoring one's rights and status.

People have used exercise, heat, and other physical methods for treatment since ancient times. However, modern medical rehabilitation developed greatly through efforts to help soldiers wounded in World War I and World War II return to society, as well as through the epidemics of diseases such as polio.

In Japan, efforts to support children with physical disabilities had already begun before World War II. After the war, related systems were gradually established, and in 1965, the Act on Physical Therapists and Occupational Therapists came into effect.

Looking into the history made me realize that rehabilitation does not simply mean "fixing the part of the body that has become damaged."

So, what is the difference between a physical therapist and an occupational therapist?

Generally speaking, physical therapists focus on recovering basic movements and physical functions, such as sitting, standing, and walking.

Occupational therapists, on the other hand, support people in recovering the movements needed for everyday life, such as eating, dressing, bathing, and doing housework. They also support people in returning to a life that is meaningful to them and in participating in society.

That was also the impression I had when I first looked around the rehabilitation room.

I saw people practicing walking, people who had received artificial hip joints, people using canes, and people pedaling stationary bicycles. Physical therapists seemed to be working with many of these patients.

So, very roughly speaking, I had thought:

"Maybe physical therapists mainly work on the lower body and walking."

However, the two therapists who specialize in my rehabilitation are both occupational therapists.

I fractured my upper arm and had surgery.

There was quite a long period between my surgery and the beginning of rehabilitation. During that time, my muscles became stiff, I had pain, and the range of motion in my shoulder was limited. External rotation was particularly painful.

At first, I could hardly raise my arm.

But now, I can raise it much more.

When my therapist measured the angle with a goniometer, I was told that it had been around 100 degrees when I was admitted, but today it was around 133 degrees.

Looking only at the numbers, someone might think, "Is that really such a big difference?"

But for me, as someone who uses this body every day, it is a significant change.

And my therapists are not simply looking at whether my arm can be raised.

They watch to see whether I am using my back to compensate.

Whether I am bending my elbow to make the movement easier.

Whether I am shrugging my shoulder.

Whether the part of my body that is supposed to move is actually moving.

They pay attention to all of these things.

Today, they worked quite a bit on loosening the areas around my stiff muscles. The trapezius, teres major, and teres minor muscles are involved. On previous occasions, they also worked on the muscles around my shoulder blade and collarbone.

And it is not simply a matter of having the therapist move my arm for me.

I am also taught exercises that I can do by myself.

I have always tended to have a rounded, stooped posture, and my therapist noticed that immediately.

I was told that if I practice external rotation while being conscious of my shoulder blade, as if I were putting my hand behind my back, my posture should improve and the range of external rotation should also improve. So I was encouraged to continue practicing little by little.

In the bath, I have started looking in the mirror to check how I am using my body.

I have finally become able to reach my right shoulder with my left hand.

But when I do that, my left shoulder rises.

"How far can I reach without raising my shoulder?"

I try to keep that in mind. Even when I wash my body with a towel, I try to use my left hand as much as possible.

Those ordinary movements of daily life can themselves become a form of training.

"Oh, so that is another way of thinking about rehabilitation."

That is what I thought.

At first, I thought an occupational therapist was simply "someone who rehabilitates the arms and hands."

But it is much more than that.

Today, I met a female occupational therapist for the first time, and she told me about occupational therapists who work in psychiatric hospitals.

She said that they may walk outside together with people who tend to stay at home because of depression, or sing karaoke with them.

They are all occupational therapists, yet the work is quite different from the shoulder rehabilitation I am receiving.

But when I think about it, both kinds of work are connected by the same goal:

helping a person regain their life.

It is not only about physical disabilities. Occupational therapists also support people, including their mental and social well-being, so that they can live their lives within society.

Perhaps that was the part of occupational therapy that had been difficult for me to understand.

Another thing I have noticed during this hospitalization is the difference between "visible disabilities" and "less visible disabilities."

When someone cannot walk, uses a wheelchair, or relies on a cane or walker, it is easy for people around them to see that rehabilitation is necessary.

But in my case, my arm itself can move. My deltoid muscle is intact. From the outside, I may look completely normal.

And yet it hurts.

I cannot move it through its full range.

I cannot use it in exactly the same way as before.

And when I move it, I sometimes compensate by using other parts of my body.

This is not easy for other people to see.

In fact, someone I met for the first time in the bath asked me:

"Where is your problem?"

That person had undergone artificial hip replacement surgery. At first, she had started with walking practice, but now she could walk freely.

Seeing her made me think:

No matter where the pain is, or which part of the body cannot be used normally, it is difficult for the person experiencing it.

There are visible disabilities and less visible disabilities.

And perhaps, because less visible disabilities are harder for other people to recognize, they can sometimes be more difficult in their own way.

That is why I think the work of occupational therapists is so important. They notice even the small movements and compensatory movements of patients like me that other people may never notice.

At this hospital, rehabilitation is provided seven days a week, including Saturdays and Sundays.

I receive rehabilitation for about 40 minutes in the morning and another 40 minutes in the afternoon.

The therapists work in shifts and take their days off according to their schedules, so from the patient's point of view, rehabilitation continues every day regardless of the day of the week.

I am very grateful for that.

At the same time, there is generally a basic guideline of about 60 days for hospitalization, and many patients are waiting.

In my case, even after my doctor approved my admission, I had to wait about a week before I could actually enter the hospital.

If no one leaves, the next patient cannot come in.

Thinking about this makes me wonder whether there really need to be more rehabilitation facilities like this.

Large hospitals are already busy performing many surgeries.

But having surgery does not mean that a person can immediately return to their previous life.

Even if a fractured bone is fixed with a titanium plate and seven screws, that alone does not restore the body to its previous condition.

The muscles and fascia around the fracture are also affected. If the body is not moved, muscle strength decreases, tissues become stiff, and movement becomes more difficult.

That is why rehabilitation afterward, over a period of time, is necessary.

There is one more thing I have found interesting since being admitted to this hospital.

The chief occupational therapist observes things such as how patients walk and how they speak, and uses these observations to determine how freely each patient can move around.

At first, a patient may have restrictions. But as their physical condition improves, those restrictions can gradually be relaxed.

Some patients are allowed to walk freely around the ward, while others are allowed to walk only within a specified area.

The same applies to bathing.

There is a hot spring bath on the fourth floor.

At first, I did not go there alone. My ability to bathe safely had to be checked.

First, I had to wash my body.

Then I could enter the hot spring.

I had to finish bathing within the designated time.

Afterward, I had to dry myself with a towel and dry my hair with a hair dryer.

Once it was confirmed that I could do all of these things by myself, I was allowed to go to the hot spring alone.

Laundry works in a similar way.

There is a step leading to the balcony, so some patients are allowed to go outside while others are not yet allowed to do so.

Basically, patients use the dryer.

When you look at each rule individually, they may seem like a collection of very detailed regulations.

Some people might even feel that they are based on an old-fashioned way of thinking.

But I have gradually come to think that these rules contain wisdom accumulated through many years of experience.

Rehabilitation is not simply about moving muscles, measuring joint angles, and then finishing the session.

It is about asking:

What can this person do now?

What can they do safely?

What can they do independently?

And once they are able to do something, which restrictions can be removed, one by one?

In this way, a person gradually regains a life that they can manage for themselves.

When I think about it that way, I feel that I am beginning to understand the original meaning of the word "rehabilitation" a little better:

restoring a person to a human and dignified state.

Until this hospitalization, I had thought about the difference between physical therapists and occupational therapists in a very simple way.

Physical therapists are for people who need help walking.

Occupational therapists are for people who need to use their arms and hands.

But after being cared for by these therapists for 12 days and doing a little research, I have realized that it is not that simple.

Moving the body and regaining one's life are actually connected.

And now, I am experiencing with my own body that my arm is gradually becoming more mobile.

An arm that can now be raised to about 133 degrees.

Practicing movement without shrugging my shoulder.

Looking in the mirror and checking how I use my body.

Trying to use my left hand in the bath.

All of these small things may be steps toward eventually returning to my own life.

I think I will stop here for today and get back to studying for the Registered Salesperson exam.

Once I start thinking about rehabilitation, I feel that there is still so much more I could say.

But if I keep going, there will be no end.

So, that is enough for today.

Day 12 in the hospital.

I feel that I now understand the word "rehabilitation" just a little better and that it has become something much more familiar to me.
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