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.