Physical therapists are healthcare providers who utilize exercise, manual therapy, and education for patients of all ages. To become a physical therapist, a candidate must earn a Doctorate of Physical Therapy, successfully pass the National Physical Therapy Examination, and achieve licensure in the state where they will practice.
Physical Therapists may also specialize by competing clinical residency programs, fellowship programs, and or become a board-certified specialist in one of eight clinical specialty areas offered by the American Board of Physical Therapy Specialties.
Patients and PT
Often, a patient is referred to physical therapy by their physician, but many states allow for direct access, meaning the patient can see a physical therapist without a referral or prescription from the doctor. The physical therapist’s evaluation starts with a thorough review of the patient’s past medical history, morbidities, medications, diagnostic tests, and work/living environment. The history includes the onset and mechanism of injury, identifies the patients prior and current functional and physical status, and includes having the patient complete a functional outcome tool, and pain assessment.
For example, a patient with knee pain may report difficulty with getting up from a chair, difficulty with stairs, and/or walking. After the history is competed and the functional limitations and impairments are identified, the PT will complete a physical exam to include observation of posture, skin integrity/edema, palpation of soft tissues, measurements range of motion and muscle length, special tests, as well as joint mobility testing. A neurological screen includes a fall risk assessment, balance and strength testing, an assessment of reflexes and sensation, as well nerve tension testing when appropriate.
Creating a Personalized Plan
After the evaluation is completed, the physical therapist determines a diagnosis and then creates personalized treatment plan based on the patient’s goals and expected outcome, called “the plan of care”. In addition to the patient's goals, the physical therapist will set achievable, measurable goals within a specified time frame. Treatment is designed to help patients improve function, mobility, manage pain and other chronic conditions, recover from injury, and prevent future injury and chronic disease.
Physical therapy treatment includes patient education, exercise to decrease pain, improve range of motion, strength, balance and joint mobility. The physical therapist will prescribe appropriate exercises, stretching, hands-on therapy and use of modalities for pain management. Every treatment session will include an assessment of the patient’s progress and response to the last treatment session as well as re-assessment of limitations in range of motion, strength, etc.
All physical therapists, no matter their specialty, have the same goal: patient mobility and function.
Physical therapist will modify the plan of care as the patient’s status and tolerance to interventions change and progress. Patient and family education is a significant part of the treatment. Patients are educated on factors that contribute to their pain and dysfunction, what to expect from the recovery process, how to manage their pain, prevent further injury, self-care management techniques, as well as long-term home exercise programs.
In my experience, there is nothing more satisfying than being a part of a patient journey back to pain-free function, health and well-being.
Physical therapists provide care in many settings including hospitals, private practices, outpatient clinics, patients’ homes, schools, sports and fitness facilities, work settings, and nursing homes. Stay tuned…next we will discuss these different types of physical therapy settings.