Topic Overview

What is physical therapy?

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 arthritis or chronic obstructive pulmonary disease (COPD).

Physical therapy may be used alone or with other
treatments.

What does a physical therapist do?

Your
physical therapist will examine you and talk to you about your symptoms and your daily activity. He or she will then work with you on a
treatment plan. The goals are to help your joints move better and to restore or increase
your flexibility, strength, endurance, coordination, and/or balance.

First, your therapist will try to reduce your pain and swelling. Your physical therapist also may use
manual therapy, education, and techniques such as
heat, cold, water, ultrasound, and electrical stimulation.

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.

Treatment may cause mild soreness or swelling. This is normal, but talk
to your physical therapist if it bothers you.

What should you look for in a physical therapist?

You’ll want a therapist who has experience with your
health problem. Some physical therapists are board-certified in areas such as orthopedics, sports, and neurology and may offer more specialized care. Physical therapists can also specialize in certain types of care, such as:

  • Back and neck pain.
  • Cardiac rehabilitation (rehab).
  • Wound care.
  • Cancer-related problems.
  • Treatment of children or older adults.

Here are some questions to think about before you choose a
physical therapist:

  • Can your doctor suggest one?
  • Do
    you need a referral from your doctor? Some states require this.
  • Will your insurance company pay for your physical therapy?

Health Tools

Health Tools help you make wise health decisions or take action to improve your health.


Actionsets are designed to help people take an active role in managing a health condition.

Types of Physical Therapy

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 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.
Also, 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
strengthen muscles,
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.

Fitness: Increasing Core Stability

Manual therapy

Manual therapy (sometimes called bodywork) is a general term
for treatment performed mostly with the hands. The goals of manual therapy include relaxation, decreased pain, and
increased flexibility.

Manual therapy can include:

  • Massage. Pressure is applied to the soft tissues of the body,
    such as the muscles. Massage can help relax muscles, increase circulation, and
    ease pain in the soft tissues.
  • Mobilization. Slow, measured movements are used to twist, pull,
    or push bones and joints into position. This can help loosen tight tissues
    around a joint and help with flexibility and alignment.
  • Manipulation. Pressure is applied to a joint. It can be done with the hands or a special device. The careful, controlled force used on the joint can range from gentle to strong and from slow to rapid.

Education

Physical therapy almost always includes
education and training in areas such as:

  • Performing your daily tasks
    safely.
  • Protecting your joints and avoiding
    reinjury.
  • Using assistive devices such as crutches or
    wheelchairs.
  • Doing home exercises designed to help with your injury
    or condition.
  • Making your home safe for you if you have strength,
    balance, or vision problems.

Specialized treatments

In some locations, physical
therapists are specially trained to be involved in other types of treatment,
including:

  • Vestibular rehabilitation, which helps your
    inner ear respond to changes in your body position. This is helpful if you have
    problems with
    vertigo, or a feeling that you or your surroundings
    are spinning or tilting when there is actually no movement. Rehabilitation
    (rehab) can help you get used to the problem so you know when to expect it. And
    rehab can train your body to know how to react.
  • Wound care. Wounds
    that are very severe or don’t heal well, often because of poor blood flow to
    the area, can require extensive care. This may include special cleaning and
    bandaging on a regular and long-term basis. Sometimes oxygen treatment or electrical stimulation is part of
    the treatment.
  • Pelvic health. Physical therapists can provide instruction in exercises to help control
    urinary incontinence or to relieve pelvic
    pain.
  • Oncology (cancer care), to help if cancer or treatment for
    cancer causes you to have problems with movement.
  • Decongestive
    lymphatic drainage, which is a special form of massage to help reduce swelling
    when the
    lymphatic system is not properly draining fluids from
    your tissues.

Other treatments

Other treatments include:

  • Cold and ice, to relieve pain, swelling, and inflammation from injuries and
    other conditions such as arthritis. Ice can be used for up 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.
  • Heat, to 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.
  • Ultrasound therapy, which 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.
  • Electrical stimulation. In
    general, this is the use of electrical current to create an
    effect in the body. Electrical stimulation is sometimes used at low levels to reduce the feeling of pain. It can also be used to cause muscles to contract (tense). And it is being studied as a
    way to help with healing of wounds and broken bones.
  • Hydrotherapy (water therapy), which is a term from the past that means the use of water to
    treat a disease or to maintain health. The most common hydrotherapy now is water exercise.

When Physical Therapy Can Help

Physical therapy and recovery from injury

Physical therapy can help you recover from an injury
and avoid future injury. Your physical therapist can help you reduce pain in the soft tissues (muscles, tendons,
and ligaments), build muscle
strength, and improve flexibility, function, and range of motion. He or she 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.

Physical therapy and chronic health conditions

Physical therapy can help you live more easily with chronic or ongoing
health conditions such as spinal stenosis, arthritis, and Parkinson’s disease. Your physical therapist will work with you to establish your
goals. Then he or she will create a program of educational, range-of-motion, strengthening,
and endurance activities to meet your needs.

Physical therapy and health conditions requiring a rehabilitation team approach

Some conditions involve several body
systems and can lead to significant disability. These conditions-such as
stroke, spinal cord injury, and major cardiopulmonary (heart and
lung) problems-are usually addressed by a team of health professionals through programs such as cardiac rehab and stroke rehab. 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.

Physical therapy and significant health conditions of childhood

Physical therapists also work with children who have
major injuries or health conditions, such as cerebral palsy. 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
treatment services.

Other Places To Get Help

Organizations

American Academy of Physical Medicine and
Rehabilitation
www.aapmr.org

American Physical Therapy Association: Move Forward (U.S.)
www.moveforwardpt.com

References

Other Works Consulted

  • 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.
  • 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.
  • U.S. Department of Labor, Bureau of Labor Statistics (2012-2013). Physical therapists. In Occupational Outlook Handbook. Available online: http://www.bls.gov/ooh/healthcare/physical-therapists.htm.

Credits

ByHealthwise Staff
Primary Medical Reviewer Adam Husney, MD – Family Medicine
Specialist Medical Reviewer Joan Rigg, PT, OCS – Physical Therapy

Current as ofMarch 21, 2017