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What is physical therapy?

Physical therapy provides services for people of all ages, from newborns to the very oldest, when medical problems or other health-related conditions limit their ability to move and function in their daily lives. A physical therapist will examine you and develop a treatment plan to increase your ability to move, reduce pain, restore function, and prevent disability.

The goals of physical therapy are to improve your mobility (such as walking, going up stairs, or getting in and out of bed), to relieve your pain, and to restore your physical function and overall fitness. Depending on your injury, disease, or condition, you may need to work on flexibility, strength, endurance, coordination, and/or balance. To do this, your treatment may focus on preventing problems or treating problems that affect:

• Your muscles, tendons, ligaments, and bones (musculoskeletal system).
• Your nerves and related muscles (neuromuscular system).
• Your heart and related blood vessels (cardiovascular system).
• Your lungs and breathing (pulmonary system).
• Your skin, including wounds and burns.
• Any combination of two or more of these.

Where can I get physical therapy?

Physical therapy services are delivered in many places, including:

• Outpatient clinics.
• Hospitals.
• Nursing homes.
• Private homes, through home health agencies.
• Schools.
• Sports and fitness facilities.
• Work settings.

How do I find a physical therapist?

Your health professional may recommend a certain physical therapist because he or she knows that the therapist has expertise with your condition and/or because they have worked together with patients in the past. Many people find their physical therapists by talking with friends or family, or even by looking in the telephone book or on the Internet. Health insurance companies also include physical therapists in their lists of providers.

Physical therapists are educated to provide services for a variety of people. Some treat a wide range of injuries, diseases, and health conditions. Others specialize in areas such as pediatrics (children's health), geriatrics (health issues of the aging), orthopedics (conditions of muscles, tendons, ligaments, and bones), sports physical therapy (recreational or professional sports issues), neurology (issues with nerves and related muscles), cardiovascular therapy (issues with the heart and related blood vessels), pulmonary (lung conditions and breathing), oncology (problems related to the treatment of cancer), and women's health (issues before and after the birth of a baby, incontinence related to muscle control in the pelvic region, problems after a mastectomy, and osteoporosis). Be sure you are seeing a physical therapist with the expertise to help with your problem, and in a setting where you feel comfortable.

Ask to find out if you need a referral from a doctor. Most states do not require a referral for you to see a physical therapist, but some do. And some insurance companies will not pay for physical therapy without a referral.

Exercise

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 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.

Getting started on core stability

Manual therapy

Manual therapy is a general term for treatment performed with the hands and not with any other devices or machines.^{1, 2} The goals of manual therapy include relaxation, less pain, and more flexibility. Manual therapy includes:

• Massage, which applies pressure to the soft tissues of the body such as the muscles. Massage can help relax muscles, improve circulation, and ease pain in the soft tissues.
• Mobilization, which uses slow, measured movements 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, which uses rapid, forceful movements to position the bones and joints. This is a more aggressive treatment. Discuss the pros and cons of manipulation with your doctor or physical therapist.

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 can help you get used to the problem so you know when to expect it, and train your body to know how to react.³
• 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.⁴ Sometimes hydrotherapy, oxygen treatment, or electrical stimulation is part of the treatment.
• Women's health. Physical therapists often work with women on 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.¹