Physical therapists, or PTs, as they’re often called, are licensed professionals who work with people that have sustained disabilities, impairments, or limitations in their overall physical function and mobility. These deviations can be the result of disease, injury, or illness. Physical therapists may also work with people to help them prevent injuries.
Physical therapists work in a variety of different settings. These include private offices and clinics, hospitals, patients’ homes, and nursing homes.
Whenever you have a physical limitation that deviates from your normal function, you may benefit from the skilled services of a physical therapist to help you regain your independence.
The American Physical Therapy Association (APTA) lists nearly 140 symptoms and conditions that physical therapists are trained to treat. Some common problems that physical therapists evaluate and treat include:
- Back Pain
- Carpal Tunnel Syndrome
- Joint Replacement
- Knee Pain
- Pelvic Floor Disorders
- Spinal Cord Injury
- Sports Injuries
Therapeutic exercise should be one of the main treatments you receive from your physical therapist: Physical therapist are movement experts, and exercise should be the primary tool your PT uses to get you moving better and feeling better.
That said, when you visit a physical therapist for a problem with pain or movement dysfunction, he or she will likely also use various interventions—called therapeutic modalities or physical modalities—to help you regain your normal functional mobility. The ones your PT chooses to use may vary depending on your specific condition, your needs, and your overall rehab goals.
- Ultrasound. The transmission of high- or low-frequency sound waves to muscles and surrounding tissue promotes relaxation and increases circulation to injured areas.
- Electrical Stimulation. This is the use of electrical current to cause a single muscle or group of muscles to contract. Along with increasing muscle strength, the contraction also promotes blood supply to the area that assists in healing.
- Kinesiology Taping or K-Tape. Special cloth tape is applied to your body to help decrease pain, improve circulation, or to facilitate muscle function.
- Transcutaneous Electrical Nerve Stimulation or TENS. A small battery-operated machine, TENS uses an electrical transmission to decrease pain.
- Light Therapy. Light therapy involves the use of lasers and light-emitting diodes at a specific wavelength to treat chronic pain, inflammation, or wound healing.
- Massage. Massage, or soft tissue therapy in PT parlance, decreases tightness in muscles and the surrounding tendons and ligaments to help provide pain-free movement.
- Phonophoresis. A cousin of ultrasound, phonophoresis involves the introduction of medication through your skin and tissues by using ultrasound.
- Iontophoresis. Another form of electrical stimulation, iontophoresis involves the use of electricity to push medication through your skin to affected muscles, tendons, or ligaments.
- Heat. Heat helps to increase circulation to the injured tissues, relax the muscles, and provide pain relief.
- Cold. A decrease in tissue temperature reduces inflammation, which, in turn, lessens pain and swelling.
- Whirlpools. Whirlpools are a form of hydrotherapy that’s used to help improve circulation, maintain clean wounds, or control inflammation. Whirlpools can be hot or cold.
- Traction. Traction is used in the treatment of low back pain and neck pain to help decrease pain and improve mobility in the spine.
- Joint Mobilization. Joint mobilization occurs when your physical therapist passively moves the joints of your body in specific directions to help decrease pain and improve mobility.
The American Board of Physical Therapy Specialties certifies nine physical therapy specialties. They include:
Cardiovascular & Pulmonary
A cardio/pulm PT specialist provides cardiac rehabilitation for patients who’ve suffered heart attacks, have heart disease, or are looking to improve overall cardiac health. Pulmonary rehabilitation, the other half of this specialty, is provided to patients who have pulmonary conditions, such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, or sarcoidosis.
Clinical electrophysiology is the physical therapy specialization that focuses on electrotherapy (aka electrical stimulation, or e-stim) and wound management. Clinical electrophysiology encompasses the evaluation, examination, and intervention of abnormal neural or muscular function. Electrotherapy can help prevent blood clots, facilitate wound healing, relax muscle spasms, improve blood circulation, and alleviate pain. It can accelerate wound healing. Common wounds treated by electrotherapy include abrasions, post-surgical incisions, diabetic ulcers, and lacerations.
Physical therapists in this specialty work with elderly patients to alleviate pain from arthritis, osteoporosis, and general joint stiffness and soreness. They also help treat patients with progressive diseases, such as Parkinson’s or Alzheimer’s, that have no cure and impact everyday activities.
Physical therapists within this specialty work with patients who have either been diagnosed with or who are recovering from cancer. PT can help with symptoms or conditions related to cancer treatment, including pain, muscle weakness, joint stiffness, loss of endurance, difficulty walking, numbness in feet and hands, and loss of bone density.
Orthopedic physical therapy involves treating conditions of the musculoskeletal system, which includes bones, muscles, ligaments, tendons, and joints. Physical therapists in this specialty may see a range of patients, such as those who suffer from arthritis, have broken bones, have had joint replacement surgery, or who’ve recently strained or sprained any muscle or ligament.
Pediatric physical therapy assists in early detection of health problems as well as the diagnosis, treatment, and management of infants, children, and adolescents with a variety of injuries, disorders, and diseases that affect the muscles, bones, and joints. Children with developmental delays, cerebral palsy, spina bifida, and torticollis are a few of the patients treated by pediatric physical therapists.
PTs in this specialty work to alleviate and heal injuries caused while engaging in an athletic activity. Common sports injuries include ACL tears, concussions, tennis elbow, hip flexor strains, and shoulder injuries, such as dislocation of the joint or rotator cuff tears.
The main goal of physical therapists in this specialty is to help maintain and promote health throughout a woman’s lifespan. These PTs can help treat specific conditions women face, such as pelvic pain and osteoporosis. They also understand women’s musculoskeletal systems and how common conditions can affect women differently than men.
Training and Certification
There are several types of degrees a physical therapist may hold. Before the end of the 1990s, only a bachelor’s degree in physical therapy was required, but students entering the field today are required to have a doctorate level degree (called a DPT). DPT programs typically last 3 years. Many programs require a bachelor’s degree for admission as well as specific educational prerequisites, such as classes in anatomy, physiology, biology, chemistry, and physics. Some programs admit college freshmen into six- or seven-year programs that allow students to graduate with both a bachelor’s degree and a DPT.
Even if your PT does not have a doctorate level degree, he or she is still qualified to provide your rehab services. The APTA allows therapists who received their degree prior to the new requirements to continue to practice.
All states require physical therapists to be licensed. Licensing requirements vary by state but all include passing the National Physical Therapy Examination administered by the Federation of State Boards of Physical Therapy. Several states also require a law exam and a criminal background check. Continuing education is typically required for physical therapists to keep their license. Check with your state boards for specific licensing requirements.
After gaining work experience, some physical therapists choose to become a board-certified specialist. Board specialist certification by the American Board of Physical Therapy Specialties requires passing an exam and at least 2,000 hours of clinical work in the specialty area within the last 10 years or completion of an APTA-accredited residency program in the specialty area.
Getting started with physical therapy is easy. If you have an injury or an illness that causes pain or prevents you from moving normally, visit your healthcare provider and ask to be referred to a physical therapist. Choosing physical therapy first—before medication or surgery—is a good idea, as PT tends to be a safe and value-packed mode of care for many conditions. Many states in the US allow you to visit a physical therapist via direct access, and no referral is needed. Ask friends and family for recommendations or use the “Find a PT” feature on the APTA website.
When preparing for your first appointment, be sure to:
Arrive early to complete any necessary paperwork. Your PT will likely have his or her own set of paperwork that you’ll need to fill in ahead of time. This can usually be accessed through the practitioner’s website. If your physical therapy is related to a workplace injury or automobile accident, bring the contact information of any necessary insurance adjusters or managers, as well as claim numbers.
Dress comfortably. When you schedule your initial appointment, ask about how you should dress. In general, you should be prepared to move around a lot. So, with that in mind, wear clothing that’s easy to move around in. If you have pain in your upper body, wear a shirt that allows easy access to your shoulder, arm, or back. Shorts should be worn if you have hip pain, knee pain, or ankle pain.
Discuss your condition. During your initial visit, your physical therapist will review your medical history and ask about your pain, capabilities, daily challenges, goals, and treatment. He or she will perform an exam that focuses on measuring impairments that may be causing your problem or that may be affected by your injury. Common measurements taken during a physical therapy examination include:
- Range of motion (ROM) measurements
- Tests of strength
- Functional mobility
- Neurological screening tests
During the examination, your physical therapist should give you clear instructions about what to expect and what to do. It’s quite common to receive homework from your physical therapist, which is intended to maintain progress gained during your office visits. Once the exam is complete, you can get started on your PT treatment plan.
The relationship you have with your physical therapist should feel like a therapeutic alliance; both of you should be working towards the goal of helping you move better and feel better. If you have questions about what’s happening during your PT treatment, just ask. Your physical therapist should encourage questions from you and should be able to provide clear, concise answers about your treatments, your condition, and your rehab program.