Physical therapy is a
type of treatment you may need when health problems make it hard to move around
and do everyday tasks. It helps you move better and may relieve pain. It also
helps improve or restore your physical function and your fitness level.
The goal of physical therapy is to make daily tasks and activities
easier. For example, it may help with walking, going up stairs, or getting in
and out of bed.
Physical therapy can help with recovery after some
surgeries. Your doctor may suggest physical therapy for injuries or long-term
health problems such as:
Physical therapy may be used alone or with other
You may get physical therapy at:
physical therapist will examine you and make a
treatment plan. Depending on your health problem, your therapist will help you
with flexibility, strength, endurance, coordination, and/or balance.
First, your therapist will try to reduce your pain and swelling. Then he
or she will probably work to increase your flexibility, strength, and
Physical therapy almost always includes exercise. It
can include stretching,
core exercises, weight lifting, and walking. Your
physical therapist may teach you an exercise program so you can do it at home.
Your physical therapist also may use
manual therapy, education, and techniques such as
heat, cold, water, ultrasound, and electrical stimulation.
Treatment may cause mild soreness or swelling. This is normal, but talk
to your physical therapist if it bothers you.
You'll want a therapist who has experience with your
health problem. Some physical therapist are board-certified in areas such as orthopedics, sports, geriatrics, and neurology and may offer more specialized care. Physical therapists can specialize in:
Here are some questions to think about when choosing a
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Learning about physical therapy:
Types of treatment:
Exercise is anything you do in addition
to your regular daily activity that will improve your flexibility, strength,
coordination, or endurance. It even includes changing how you do your
regular activities to give you some health benefits.
For example, if you park a little farther away from the door of the grocery
store, the extra distance you walk is exercise.
Physical therapy nearly always involves exercise of
some kind that is specifically designed for your injury, illness, condition, or
to help prevent future health problems. Exercise can include
stretching to reduce stress on joints, core stability
exercises to strengthen the muscles of your trunk (your back and abdomen) and
hips, lifting weights to
walking, doing water aerobics, and many other forms of
activity. Your physical therapist is likely to teach you how to do an exercise
program on your own at home so you can continue to work toward your fitness
goals and prevent future problems.
Manual therapy is a general term
for treatment performed with the hands and not with any other devices or
machines. The goals of manual therapy include relaxation, less pain, and more
flexibility. Manual therapy includes:
Physical therapy almost always includes
education and training in areas such as:
In some locations, physical
therapists are specially trained to be involved in other types of treatment,
Ice and cold packs are used in
physical therapy to relieve pain, swelling, and inflammation from injuries and
other conditions such as arthritis. Ice can be used for 10 to 20 minutes at a
time. In some cases, ice may be used several times a day. Some therapists also
use cooling lotions or sprays. For more information, see:
Heat can help relax and heal your muscles and
soft tissues by increasing blood circulation. This can be especially helpful if
a joint is stiff from osteoarthritis or from being immobilized. Heat can also
relax the muscles before exercise. But heat can also increase swelling in an
injured area if it is used too soon. For more
Hydrotherapy is the use of water to
treat a disease or to maintain health. The term "hydrotherapy" (water therapy)
can mean either exercise in the water or using water for care and healing of
soft tissues. This type of therapy is based on the theory that water has many
properties that give it the ability to heal.
For more information, see
uses high-pitched sound waves to ease muscle spasms and relax
and warm muscles before exercise, to help relieve pain and inflammation, and to
promote healing. Although the use of ultrasound is common, some studies show a
benefit from this treatment and others do not. Some physical therapists do not
recommend deep-heating techniques. Discuss the benefits and risks with your
physical therapist or doctor before starting this therapy. This type of
treatment is not generally used for children.
Electrical stimulation is
the general term that describes the use of electrical current to create an
effect in the body. There are several uses for electrical stimulation.
physical therapy visit, your
physical therapist will review your medical history
and do a physical evaluation. Depending on your diagnosis or symptoms, your
therapist may evaluate your flexibility, strength, balance, coordination,
posture, and/or heart rate and respiration. Your therapist may look at how you
walk or get up from lying down (functional activities), along with how you use
and position your body as you perform activities (body mechanics). The
therapist will work with you to decide on your goals for physical therapy and
to begin planning your treatment. You may or may not begin your actual therapy
at the first visit.
In general, the first goal of treatment is to
decrease any pain and swelling you may have. The next steps usually are to
increase your flexibility and then to increase your strength and endurance, depending on your condition. The
goal is always to improve your ability to do your daily tasks and activities.
As with any exercise, you may have mild soreness or swelling as a result of
treatment, and these should be noted by your therapist. Your therapist will
watch your reaction to treatment (for example, if you have swelling or become
out of breath) and will adjust your treatment as needed. This ongoing
assessment and adjustment means that the risk of any injury or complication
from physical therapy is very low.
Your physical therapist will
evaluate your need for special equipment such as particular footwear, splints,
or crutches. If you need equipment, your therapist can help you know what to
get and either get it for you or tell you where you can find it.
In most cases, part of your physical therapy will be education. Your
therapist may teach you about a home exercise program, proper body mechanics,
and the use of any special equipment you may need. He or she will then
periodically check on how well you are transferring the skills you learn in
therapy to your daily life.
Your physical therapist will
continually reassess your progress toward your treatment goals. He or she will work
with you and your doctors to plan for your discharge from physical
can help you recover from an injury
and avoid future injury by reducing pain in the soft tissues (muscles, tendons,
and ligaments), improving flexibility and function, and building muscle
physical therapist can also evaluate how you do
an activity and make suggestions for doing the activity in a way that is less
likely to result in an injury. Following are examples of injuries for which
physical therapy is helpful:
Physical therapy can help you live more easily with chronic or ongoing
health conditions. Your physical therapist will work with you to establish your
goals, then create a program of educational, range-of-motion, strengthening,
and endurance activities to meet your needs. Here are some examples of chronic
conditions that may be helped by physical therapy:
Some conditions involve several body
systems and can lead to significant disability. These conditions—such as
stroke, brain injury, spinal cord injury, and major cardiopulmonary (heart and
lung) problems—are usually addressed by a team of health professionals. The
team can include doctors; nurses; physical, occupational, and speech
therapists; psychologists; and social workers, among others. Physical
therapists are a critical part of this team. They address the issues of range of
motion, strength, endurance, mobility (walking, going up and down stairs,
getting in and out of a bed or chair), and safety. The physical therapist may
also get you the equipment you need, such as a walker or wheelchair, and make
sure you can use the equipment appropriately. Following are some examples of
health conditions that commonly involve a rehabilitation team:
Physical therapists also work with children who have
major injuries or health conditions. They address the usual issues
of range of motion, strength, endurance, and mobility. Also, the therapist considers the child's special growth and developmental needs.
Treatment is often provided in the school or in a facility just for
children. The way physical therapy and other services are delivered in the
schools varies among the states. Talk to your child's doctor, school, or your
local health department if you think your child may qualify for evaluation or
Cerebral palsy is an example of a childhood health
condition that is usually addressed in part by physical therapy. Other injuries
and conditions include brain injury, muscular dystrophy, and arthritis.
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise.
The American Academy of Physical Medicine and
Rehabilitation (AAPMR) is the medical society for the specialty of physical
medicine and rehabilitation. The website includes a directory of member
PM&R physicians (physiatrists) that can be searched by last name, location,
or telephone number.
The American Occupational Therapy Association (AOTA) is the
nationally recognized professional association of approximately 35,000
occupational therapists, occupational therapy assistants, and students of
occupational therapy. AOTA's mission is to advance the quality, availability, use,
and support of occupational therapy through standard-setting, advocacy,
education, and research on behalf of its members and the public.
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
The American Physical Therapy Association (APTA) Move Forward website provides information
and education to the public about physical therapy and how it is used to treat
certain conditions. APTA is a national
organization representing over 85,000 physical therapists, physical therapist
assistants, and students. APTA's goal is to foster advancements in physical
therapist education, practice, and research.
Other Works Consulted
American Physical Therapy Association (2009). Criteria for standards of practice for physical therapy. Available online: http://www.apta.org/AM/Template.cfm?Section=Home&Template=/CM/ContentDisplay.cfm&ContentID=68019.
American Physical Therapy Association (2012). Who are physical therapists? Available online: http://www.apta.org/AboutPTs.
Basford JR, Baxter GD (2010). Therapeutic physical agents. In WR Frontera et al., eds., Physical Medicine and Rehabilitation: Principles and Practice, 5th ed., vol. 2, pp. 1691–1712. Philadelphia: Lippincott Williams and Wilkins.
Becker BE, Cole AJ (2005). Aquatic rehabilitation. In JA DeLisa et al., eds., Physical Medicine and Rehabilitation: Principles and Practice, 4th ed., vol. 1, pp. 479–492. Philadelphia: Lippincott Williams and Wilkins.
Cotter AC, et al. (2005). Complementary and alternative medicine. In JA DeLisa et al., eds., Physical Medicine and Rehabilitation: Principles and Practice, 4th ed., vol. 1, pp. 465–478. Philadelphia: Lippincott Williams and Wilkins.
Ho CH, Bogie K (2010). Pressure ulcers. In WR Frontera et al., eds., DeLisa's Physical Medicine and Rehabilitation: Principles and Practice, 5th ed., vol. 2, pp. 1393–1409. Philadelphia: Lippincott Williams and Wilkins.
Malanga GA, et al. (2010). Sports medicine. In WR Frontera et al., eds., DeLisa's Physical Medicine and Rehabilitation: Principles and Practice, 5th ed., vol. 2, pp. 1413–1436. Philadelphia: Lippincott Williams and Wilkins.
Pape KE, Chipman ML (2005). Electrotherapy in rehabilitation. In JA DeLisa et al., eds., Physical Medicine and Rehabilitation: Principles and Practice, 4th ed., vol. 1, pp. 435–463. Philadelphia: Lippincott Williams and Wilkins.
Parikh SS, Bid CV (2005). Vestibular rehabilitation. In JA DeLisa et al., eds., Physical Medicine and Rehabilitation: Principles and Practice, 4th ed., vol. 1, pp. 957–974. Philadelphia: Lippincott Williams and Wilkins.
U.S. Department of Labor, Bureau of Labor Statistics (2012–2013). Physical therapists. In the Occupational Outlook Handbook. Available online: http://www.bls.gov/ooh/healthcare/physical-therapists.htm.
Weiting JM, et al. (2005). Manipulation, massage and traction. In JA DeLisa et al., eds., Physical Medicine and Rehabilitation: Principles and Practice, 4th ed., vol. 1, pp. 285–309. Philadelphia: Lippincott Williams and Wilkins.
March 4, 2011
Adam Husney, MD - Family Medicine
& David A. Fleckenstein, MPT - Physical Therapy
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