What is physical therapy?
Physical therapy (PT) is a form of healthcare that uses physical activities to help you move better and feel good in your body. Also known as physiotherapy, physical therapy is practiced by physical therapists, who treat patients using specific forms of exercise, stretching and hands-on manipulation, along with complementary techniques like massage. The goal is to help relieve pain as well as improve mobility, coordination, flexibility and other related body functions. Physical therapy works mostly with the musculoskeletal system of your body: your muscles, joints, tendons, ligaments and bones.
Physical therapy is commonly used to help people recover from injury. It can also help patients to treat or adjust to other structural issues that may arise in the body, including those that result from disability, chronic illness or aging. People who have recently undergone surgery often receive physical therapy as part of their recovery process. Many people with neurological conditions also benefit from physical therapy. Sports medicine makes extensive use of physical therapy as a means of helping athletes to perform better and heal more quickly.
Physical therapists also provide education for their patients, and practical guidance on how to function with injury or disability.
Physical therapists are either doctors of physical therapy (DPTs) or another form of licensed practitioner. A physical therapist may treat a patient on their own, or work in consultation with other health care professionals. Physical therapists often work at clinics, hospitals or offices, however, many also make home visits.
How does physical therapy work?
Physical therapists assess, diagnose, and treat biomechanical issues with the body. Working with a physical therapist usually involves regular appointments either in office or at home. While other doctors often prescribe medication or changes in diet, DPTs prescribe exercise.
History and philosophy
Healers have always worked to improve the mechanics and structure of the body, to help people move better. However, modern physical therapy is often described as beginning in the 19th century. Per Henrik Ling, a doctor who is often credited as having helped develop the Swedish style of massage, was one of the first to research exercise as a form of healing. Ling founded a school for exercise studies in 1813.
The concept spread. By the early 20th century, universities around the world were training students in the growing field of physical therapy. Other related forms of medicine, like chiropractic and osteopathic manipulative therapy, were also being developed at the time. The first and second world wars highlighted the need for health professionals who could help wounded soldiers adapt to and recover from their injuries, further establishing the usefulness of the practice.
Today, physical therapy is a thriving and integrated part of most systems of health care. People of all ages receive physical therapy. Doctors increasingly refer their patients to physical therapy as an alternative to undergoing many surgical procedures, or to help them recover.
Physical therapists themselves are guided by the principle that movement is an essential part of life, and that it is their duty to help their patients move as freely and painlessly as possible.
Physical therapy is an evidence-based school of medicine. The practice is grounded in the scientific understanding of the human body, and uses techniques that are supported by research. Physical therapists have a thorough understanding of the science underpinning their work, including kinesiology and anatomy.
Studies have found that physical therapy is an effective treatment option for many health conditions. In addition, the relationship between the physical therapist and patient has been identified as being a key part of the healing process. People who felt they could communicate openly and easily with their physical therapist reported better outcomes across the board.
Physical therapists use a wide range of techniques to help their patients. The specific approach depends on the therapist's diagnosis, someone seeking relief for back pain will likely receive a different treatment than someone rehabilitating after surgery. However, all physical therapy relies heavily on forms of exercise and bodywork to help you heal.
During a typical session, a therapist may show you a series of stretches or exercises. The therapist or an assistant will then supervise you while you go through the exercises, and offer guidance as needed. The therapist may also use hands-on manual manipulation techniques, massage, dry needling (similar to acupuncture), hot or cold pads, or other healing approaches during the session.
There is no set time limit for being in physical therapy. Some people may only need a few sessions. Others may benefit from a longer period of treatment.
Types of physical therapy
There are specialties within the field of physical therapy. Some of the most common include:
Fitness, sports medicine and performance: a branch of physical therapy aimed at improving athletic performance and speeding recovery times.
Geriatric physical therapy: helps older adults to function better and live with less pain.
Women's health: physical therapy can help women recover from pregnancy, as well as work with pelvic pain.
Neurological physical therapy: helps people recover from and adapt to limitations resulting from neurological conditions including brain injury, stroke and Alzheimer's.
Orthopedic physical therapy: focuses on recovery from injury.
Pediatric physical therapy: physical therapy for children and teenagers.
Cardiopulmonary physical therapy: helps people with a range of cardiovascular or pulmonary conditions to function more easily and with greater endurance.
What are the benefits of physical therapy?
Physical therapy can be useful to anyone who wants to relieve musculoskeletal pain, improve the performance of their body, or just move around with greater ease. Some of the specific benefits of physical therapy can include:
Physical therapists can help treat your back, neck, or other musculoskeletal pain. Techniques like massage and dry needling have been proven effective at reducing muscle tension and relieving pain. Other aspects of physical therapy - like exercises that may improve your posture, for example, can also help, by reducing the strain on specific areas of your body.
Recovering from injury
Physical therapy can be an important part of recovering from injury. Many injuries can reduce your mobility, or make it harder to do things you used to take for granted. Physical therapy can often either help you get back to where you were, or help you adapt to any limitations resulting from your injury.
Improving athletic performance
Many athletes (and non-athletes) use physical therapy to help improve their physical performance. This includes balance, mobility, flexibility, coordination, body mechanics, posture, and endurance. Improving your abilities in these areas can also help you avoid injury.
Avoiding or recovering from surgery
Physical therapy can help you avoid surgery. Along with other hands-on healing approaches, physical therapy is frequently used as a treatment for back or neck pain, or other musculoskeletal issues. These conditions are sometimes treated surgically, but physical therapy offers a safer, less expensive alternative that is often more effective. For example, people suffering from arthritis who received physical therapy as treatment experienced the same level of success as people who underwent surgery, but without the risk and expense of a surgical procedure.
For those recovering from surgery, physical therapy can also be an important part of the process. It can help you rebuild your body, and get back to moving freely.
Many older adults benefit from physical therapy as preventative maintenance. Working with a physical therapist can help you age more comfortably, as they can help you support your body and avoid or adapt to physical limitations related to age. They can also provide education on how to exercise safely.
Recovering from a stroke
A stroke can often be debilitating. It is not uncommon to have difficulty moving after a stroke. This can range from trouble with coordination to some degree of paralysis. Physical therapy can often help you learn to move again.
Mental and emotional wellness
Not being able to move well isn't just a physical problem. It can be profoundly frustrating to experience significant physical limitations, which can lead to ongoing feelings of depression and anxiety. By reducing or moving you past those limitations, physical therapy can also help you feel better mentally and emotionally.
Safety and side effects
Physical therapy is safe and has few side effects when performed under the guidance of a licensed physical therapist. Some people may experience soreness during or after a session. However, that does not typically last long.
If you do have any serious health conditions, it is a good idea to discuss them with your physical therapist before beginning treatment. This can help your physical therapist to choose the safest and most appropriate interventions.
The following experts reviewed and contributed to this article:
The Influence of the Therapist-Patient Relationship on Treatment Outcome in Physical Rehabilitation: A Systematic Review
Amanda M. Hall, Paulo H. Ferreira, Christopher G. Maher, Jane Latimer, Manuela L. Ferreira
Physical Therapy, 2010
Surgery versus physical therapy for a meniscal tear and osteoarthritis.
Jeffrey N. Katz, M.D., et al
The New England Journal of Medicine, (2013)