‘Early posture checks and mobility can make hospitals half-empty’

When Dr. Ashwini Shelke walks into a room, she isn’t just looking at your smile - she’s reading your posture like a lifelong manuscript. As a senior physiotherapist who accompanied the Indian sailing team to the 2024 Paris Olympics, Dr. Ashwini has spent her career at the intersection of elite performance and everyday longevity.

Currently the Lead Physiotherapist at Invictus Performance Lab, Bengaluru, Dr. Ashwini is on a mission to dismantle the myth that physiotherapy is reserved for the sporting elite. Whether she is treating an athlete chasing gold or a senior citizen reclaiming their balance, her philosophy remains the same: the body’s story can always be rewritten through movement.

With a master’s specialisation in Manual Therapy and a tireless work ethic, Dr. Ashwini brings a blend of clinical precision and humour to the science of motion. Read on to discover why she believes movement isn’t just a physical act - it’s the ultimate key to human longevity. In an interaction with CS Krishnamurthy she breaks various myths about physiotherapy. Excerpts…

Physiotherapy is often seen only as post-injury care. How can we shift this perception toward preventive healthcare?

In India, especially in rural areas, physiotherapy is often misunderstood as mere massage or basic exercise rather than evidence-based medical practice. To change this, education is vital. It is not a temporary fix for symptoms; it is an active patient partnership.

Just as we prioritise regular blood tests, people should consult a physiotherapist to optimise posture, strength, and balance before pain starts. This proactive approach maintains healthy movement for life. People mostly see us only when they limp in.

If more people did posture checks and mobility drills early, hospitals would be half-empty.

Many people rush for scans (MRIs/X-rays) at the first sign of pain. How important is body awareness compared to a formal diagnosis?

We need to listen to ‘quiet’ signals like stiffness or restricted movement before they become ‘loud’; injuries. While scans are useful, they aren’t always the necessary first step. Many aches improve with early, targeted exercises. Building body awareness allows for minor corrections that prevent major tears.

How does treating an Olympic athlete differ from treating a sedentary professional?

The core principles - assessing movement, strength, and recovery - remain the same. What changes is the context. For an athlete, performance means elite competition; for a professional, it might mean working eight hours without pain. Performance is personal. Whether the goal is running an ultra-marathon or walking a kilometer pain-free, the gap between the athlete and the professional is smaller than we think. Both need balance - too much motion without rest, or too much rest without motion, are equally harmful. My work is to remind both that mindful movement is medicine.

Are youngsters ‘aging’; their spines prematurely due to screen usage and ‘hustle culture’?

Technology isn’t the villain, but our sedentary habits are. The ‘text-neck generation’ suffers because of prolonged static postures. Also, when long hours and poor nutrition persist, the body pushes back with chronic fatigue. The solution isn’t perfection but balance: small habits like neutral sitting positions, staying hydrated, and taking standing breaks quietly protect the body from a high-pressure lifestyle.

How have changing Indian habits, like moving from floor-sitting to sofas, affected our mobility?

It is a use it or lose it; scenario. Traditional habits like squatting and walking barefoot kept our joints flexible and feet strong. By gently reintroducing floor movements and foot-strengthening exercises into modern life, we can regain that lost mobility.

Women often endure pelvic or back pain in silence. Why is this, and how do you support them through transitions like menopause?

Societal conditioning often frames this pain as ‘normal’; after childbirth. Awareness is particularly low in rural areas due to lack of private spaces or stigma. However, hormonal shifts throughout a woman’s life – from pregnancy to menopause - drastically affect bone density and joint stability. Physiotherapy goes far beyond postnatal care; it provides tailored guidance to help women stay stable and strong through every hormonal milestone. When women start viewing physiotherapy as strength-training for life, not just recovery, remember, the entire household benefits.

For senior citizens, what are the most common mistakes made regarding joint health and the fear of falling?

Many believe they must be ‘fit enough’; before starting physiotherapy. In reality, strength training is the tool used to reach that fitness. Also, many assume a one-hour workout compensates for 23 hours of inactivity. Regarding falls, fear of movement can be as debilitating as the injury itself.

We start with gentle, controlled movements to manage pain. Confidence grows through measurable success - tracking progress in balance and strength allows patients to trust their bodies again, and independence returns.

Can physiotherapy truly transform independence for differently-abled individuals?

Absolutely. Physiotherapy is about empowerment. I recall a patient paralysed from the waist down who suffered severe shoulder pain from wheelchair use. While we could not restore leg movement, we focused on upper-body conditioning. Within six months, she could perform 30 full push-ups. Her pain vanished, and her increased stamina transformed her daily life.