The profession of physical therapy in the United States was actually begun in the aftermath of WW 1. The US Army Medical Corps established the first reconstruction units and trained Reconstruction Aids to rehabilitate wounded soldiers to return to a productive life. Mary McMillan, a civilian trained in England in basic science and exercise, developed the first physical therapy program at Walter Reed Hospital. The first physical therapy classes were taught by McMillan at Reed College to 208 women. In all over 800 women were trained to work in army units in the United States and Europe during the war.
In 1921, with the establishment of the American Women’s Physical Therapeutic Association after the war, the seeds of a new profession were sown. Originally consisting of only women, the Association’s name was changed to the American Physiotherapy Association to include men in its membership. Physical therapy practice at that time was directly under the guidance of a physician and was limited to hospitals, both military and civilian, and a few outpatient clinics.
The need for trained physical therapists again spiked with the advent of WW II. Walter Reed Hospital took the lead in establishing emergency training sessions and soon other military hospitals followed suit. By the end of the war the number of physical therapists serving in the army had risen from 250 to 1632.
After the war physical therapists were instrumental in the treatment of poliomyelitis and its after affects. With the increased demand, the number of practicing physical therapists rose to 8000.
Slowly physical therapists sought to be more than skilled hands. They became involved in all aspects of treatment and helped with research into the efficacy of treatments for the devastating effects of polio. The need for a stronger professional organization emerged as well. The name was changed to the American Physical Therapy Association (APTA) and a board of directors and house of delegates was established to develop policies and standards for the profession.
The modern profession of physical therapy has expanded to provide many services including pain relief, increasing functional mobility, retraining weakened muscles, preventing disabilities and allowing people to achieve their maximum potential following disease or accident. Physical therapists treat patients from cradle to grave without regard to sex, race or religious affiliation. If a need exists a therapist will be there to help.
Originally physical therapy or physiotherapy as it is known in Europe and Canada was very inclusive of almost all physical disabilities. As the profession progressed, specific treatments became the focus of other health care professionals, thus the birth of respiratory and occupational therapy. Athletic training also developed as a specialty servicing athletes both on and off their field of play.
What does it take to become a physical therapist?
Educational requirements at present are a post baccalaureate degree from an accredited physical therapy school in the US. Undergraduate prerequisites include courses in biology, chemistry and physics as well as social sciences. A rigorous program awaits the PT student including gross and neuroanatomy, kinesiology, pathophysiology and specific courses geared to evaluation and treatment of physical limitations.
The American Physical Therapy Association (APTA) has strongly encouraged a progression to a doctorate level program. In it’s vision statement by the year 2020 physical therapy will be "performed by Doctors of Physical Therapy"1. The doctor of Physical Therapy degree (DPT) is a clinical degree comparable to a DDT or PharmD degree. The goal of the APTA is to advance the practice of Physical Therapy to the level accorded pharmacists, dentists, etc. in becoming recognized as an autonomous profession.
To practice in the United States a PT must pass a national board exam and be licensed in her state of residence. State laws very regarding Direct Access, the ability of a physical therapist to practice without a referral from another professional such as a physician, M.D. or O.D. Initially all states required a prescription from a physician for physical therapy treatments to be administered. With the help of the APTA, more states are now changing state laws to allow the physical therapist to be the first entry point into the health care system.
Like the idea of helping people but don’t want to invest the time or money?
Becoming a physical therapist assistant (PTA) may be a viable option for you. PTA’s perform a number of physical therapy treatments and procedures as determined by the supervising physical therapist. They work much like a nurse does in following a treatment plan as established by a physician.
PTA’s complete a 2 year program of study earning an associate degree from an accredited physical therapy program. Like PT’s they must pass a licensure exam to practice physical therapy.
One way to determine if you would be interested in a career in physical theory is to work as a physical therapist aid. Physical therapist aids are unlicensed assistants who perform routine supportive tasks such as cleaning treatment areas or transporting patients. Aids are always under the direct supervision of a physical therapist.
Aside from the academic requirements, patience and a caring heart are essential in becoming a physical therapist. Physical therapy is a service profession and requires the same personal qualities you would look for in a good nurse: compassion, strength of character and the ability to focus on treating the whole person, not just his disability. The basic skills needed to treat patients can be taught to anyone. How to apply those skills to help an elderly woman return to independent living after a hip fracture or to motivate a young disabled child to develop the strength to walk through play cannot. The greatest satisfaction in this field can be found when your patients have achieved their goals and no longer need your services.
Physical Therapists are experts in the movement and functioning of the body. As such they practice in a wide range of settings including but not limited to nursing homes, hospitals, schools, outpatient clinics and patients homes. They might just as easily be found at a factory determining the most ergonomic method of performing a task or out on a field training an Olympic athlete or even teaching a group of nurses the correct lifting techniques to prevent back injuries. More academically inclined PT’s may be found teaching and conducting research on the best functional outcomes of treatment strategies.
PT’s interested in extending their knowledge base can become certified specialists. The specialist certification program was established
to provide formal recognition for physical therapists with advanced clinical knowledge, experience, and skills in a special area of practice and to assist consumers and the health care community in identifying these physical therapists1.
The Seven areas of clinical specialization include geriatrics, neurology, orthopedics, pediatrics, sports, clinical electrophysiology and cardio/pulmonary. Each specialty determines the requirements for their field but the minimum requirements are 2,000 hours of clinical practice in the specialty area, 25% of which must have occurred within the last 3 years and passing the specialty exam in the area of choice.
Finally the PT is an educator and a teacher. The fundamental goal of any treatment plan is to give the patient the ability to take charge of their own health. Therapeutic exercise and functional training are the foundation of this approach. Exercise programs are designed specifically for each patient. Patients are then instructed in the correct performance and execution of the exercises until the patient can perform them on his own.
Under the guidance of a physical therapist, patients also learn methods for injury prevention, compensation techniques, and postural correction. For those of you spending long hours at your computer; are you sitting correctly with low back supported and feet firmly on the floor? Or do you crane your neck forward and round your shoulders sitting at the edge of your seat? If you suffer from back and /or neck pain (maybe not now but you will if you keep it up) look at your chair, posture and computer arrangement.
The following list contains some of the most common reasons to see a physical therapist:
- Sprains and muscle strains
- Cardiac rehabilitation
- Rehabilitation after a serious injury
- Chronic respiratory problems
- Stroke rehabilitation
- Problems with balance
- Low Back Pain
- Shoulder, arm, wrist or hand problems
- Knee, ankle or foot problems
- Carpal tunnel syndrome
- Disabilities in newborns
- Women’s health including pre-/post natal and incontinence
- Fitness and wellness programs
- Hip fractures
- Chronic and Acute wounds
- Total joint replacements
For a quick overview of specific PT treatments see node by lunarius.
So the next time you are at the gym working out and you realize you have really mucked something up, contact a physical therapist and find out the correct way to exercise and keep your self in good shape.
1. The American Physical Therapy Association http://www.apta.org/
U.S. Department of Labor Bureau of Labor Statistics Occupational Outlook Handbook http://www.bls.gov/oco/ocos167.htm
Saunders Manual of Physical Therapy Practice, Rose Sgarlat Myers, PT, PhD, CAE W.B. Saunders Company, Philadelphia, PN, 1995