What is Physical Therapy exactly?

Isn’t physical therapy just exercise? Can’t my chiropractor do physical therapy? Can’t I get physical therapy from a personal trainer or at the gym?

These are commonly asked questions. The answer to all of them is NO. I’ll get to why in a minute.

Let’s start broadly and then get more specific. Here is an official answer (warning: dry wording ahead):

Physical therapy is the application of evaluation and/or treatment to movement dysfunction as provided by a licensed physical therapist.

Great, there’s the official answer. Now let’s see what this means in practice.

Physical therapy is the application of evaluation…

As discussed earlier, PTs are movement specialists and we treat movement dysfunction in its many forms. In order to identify the dysfunction and its effect we must do an evaluation. This involves acquiring information through interview (including medical history), taking measurements and making observations about movement and of the health of the neural, muscular, and skeletal systems, and screening to rule out more sinister contributions that require another professionals expertise. Evaluation allows the physical therapist to assess the situation and come up with an appropriate plan to move forward.

…and/or treatment of movement dysfunction…

Once the evaluation is completed treatment is initiated, if needed. The treatment will vary based on the needs identified in the evaluation. Some of the many examples of physical therapy treatment include many forms of manual therapy (using our hands), movement therapy with its many variations, conditioning (exercise is a part of this), electro and thermal modalities, and education. These treatments are not physical therapy themselves but are some of the various ways in which a therapist may treat. In other words, exercise is not physical therapy and neither is ultrasound. For example, school teachers also use education for their jobs. Does that mean a school teacher is providing physical therapy when they teach? Of course the answer is no.

…as prescribed by a licensed physical therapist.

Physical therapy describes the skilled work done by a physical therapist. As you can see from the above there are many skills involved in providing physical therapy. Common misconceptions are that physical therapy is “just exercise” or something of that nature and this describes us by one tool that we might use. Let me highlight one problem that arises with this misconception.

In most states the term “physical therapy” is protected. In other words you can’t advertise that you offer physical therapy unless you have a licensed physical therapist on staff, just like you can’t claim to practice medicine without a medical license. Makes sense, right? The state of Oregon is one exception. Many chiropractors in the state of Oregon advertise that they provide physical therapy, physiotherapy, or physiotherapuetics (terms that confuse the consumer), or physical therapy modalities when in fact they do not, because the term is not protected there. They may offer exercises and modalities and other rehabilitation related treatments, but that is not physical therapy, as I just described above. It is chiropractic. It would be the same as a PT claiming they can offer chiropractic because they do spinal manipulation. That would be false as well as demeaning to the chiropractors. This is a frustrating state of affairs for physical therapists in and around Oregon because it belittles the complexity of what physical therapy offers and allows the chiropractic profession to do as they wish with our professional title including gain from its promotion, or belittle its meaning to that of an ultrasound machine or exercise ball.

Well, I got onto my soapbox there a bit, but hopefully you can now go back up to the 3 questions at the top of this post and understand why the answer to each is no.

Day to day in the clinic and around the community I frequently encounter misconceptions about what physical therapy is and who physical therapists are. I suppose this state of affairs is true of a lot of professions, but I find that these misconceptions often influence when and why a person might seek the care of a therapist.

Here are a few questions about who we are that I am often asked:
- How much school did you have to go through?
- Do you guys just treat athletes?
- What types of problems do you treat?

First and foremost, physical therapists are specialists in treating movement dysfunction. We have a variety of ways to deal with a variety of movement problems. These problems may consist of the issues that come with a stroke, a spinal cord injury, cerebral palsy, or from having had an amputation. There are many many disorders and diagnoses that might bring about movement dysfunction. Then there is pain. Pain often creates movement dysfunction as well. It can limit your amount of movement, decrease your tolerance to movement, and make functioning annoying, difficult, or flat out impossible.

Physical therapists are trained and licensed professionals. We must graduate from an accredited physical therapy program. A typical duration of schooling for a physical therapist is 6-7 years of undergraduate and post-graduate university training (and yes it did feel like a long time!). After graduation we must pass a state licensure examination. Each year we must update our training with continuing education courses.

It is a very rewarding profession and well worth the effort it takes to become one.

A very common question I am asked next is: "Isn't that a lot of school to learn about exercise?" In order to answer this I need to address what is physical therapy, which I will do in the next post.....

In the meantime, please feel to add any other questions you can think of about who are physical therapists and I will answer them.

Cory Blickenstaff PT
Forward Motion Physical Therapy

Welcome to my blog. My name is Cory Blickenstaff and I am a physical therapist. I own and operate a clinic in Vancouver, WA called Forward Motion Physical Therapy. I am a board certified specialist in orthopaedics and a certified strength and conditioning specialist. While physical therapists help a wide variety of people with a wide variety of problems, my particular interest is in helping people in pain. These people may be young or elderly, elite athletes or couch potatoes, dealing with new pains or with very old and persistent pain. They may have any number of medical diagnoses. I see people at many places on many spectrums. If they hurt when they move I try to help them.

This blog will often be about discussing issues involving physical therapy, pain, and its treatment. I will hope to keep it entertaining, bringing in seemingly unrelated topics and tying them in to what it is to experience and recover from pain.

Also of concern to me is protection of the consumer. Searching for effective health-care today is daunting. There are as many resources as there are people to ask and often times advice is conflicting. Oprah may say one thing while your physician says quite another and a chiropractor tells you a third. In this time of easy to access information there is a lot of opportunistic marketing around to prey on the unsuspecting health-care consumer.

The second purpose of this blog will be to examine some of these issues. We'll discuss some of the marketing ploys out there, how to recognize the deceitful ones, and where to find good information. Consumer protectionism if you will.

Feel free to comment on my posts and join in the discussion.

Cory Blickenstaff PT

Labels: consumer protection, introduction, pain, physical therapy