National Physical Therapy Month: An Expert’s Advocacy Guide for PTs

“Across the country, whether you look in private practice, or in rehabilitation, or in hospital settings, the growth in the field of physical therapy is just phenomenal.”

Richard Shields, PhD, Chair of the Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine at the University of Iowa

On January 15, 1921, the founders of what would come to be known as the American Physical Therapy Association (APTA) gathered at a steakhouse in New York City to discuss the future of their profession. The 100 years that followed that first meeting have brought enormous changes to the field of physical therapy. What started as a profession primarily concerned with getting war veterans and casualties back up on their feet is now a highly scientific and broad-ranging field that helps people manage pain, recover from injuries, reduce the risk of future injury and chronic disease, and improve overall life quality.

October is National Physical Therapy Month (NPTM), a time to celebrate the growth of the profession of physical therapy and all the ways physical therapists (PTs), physical therapist assistants (PTA), and physical therapy students help improve people’s lives across the country. This year’s theme for NPTM is focused on the importance of physical activity, and on spreading awareness around the tangible benefits of movement and exercise.

To learn more about how the field of physical therapy has evolved over time, and to find out where it’s going, read on.

Meet the Expert: Richard Shields, PhD, PT, FAPTA

Dr. Richard Shields is the current chair of the Department of Physical Therapy and Rehabilitation Science within the Carver College of Medicine at the University of Iowa. He earned his BS in biology from Catawba College, his certificate in physical therapy from the Mayo Clinic of Health Related Sciences, and both his MA and PhD in exercise physiology from the University of Iowa.

Dr. Shield’s central research theme is prescribed activity: exercise as medicine. He has published over 100 scientific papers, delivered over 200 scientific presentations, and had his research funded for the last 20 years by the National Institutes of Health (NIH), the Department of Veterans Affairs (VA), and several private foundations.

Dr. Shields was the recipient of the Iowa Neurology Clinical Research Award, the APTA Neurology Section Research Excellence Award, the University of Iowa Outstanding Mentor and Teaching Award, the Mayo Clinic Outstanding Alumnus Award, the American Physical Therapy Association (APTA) Williams Research Award, the research section’s Maley Research Award, and named a Catherine Worthingham Fellow from the APTA.

The Evolution of Physical Therapy

“This profession is still young, but it’s grown enormously,” Dr. Shields says. “Thirty years ago, there were only 10 to 15 schools for physical therapy, and now there are over 250 accredited physical therapy programs. Physical therapy is a bona fide healthcare group, and physical therapists are well-recognized for their value and their contributions to the healthcare team. They’re really a key part of the interprofessional group of healthcare providers. Physical therapy crosses every part of medicine, and it would be very hard to come across a practice in healthcare today that rehabilitation isn’t an important element of.”

Physical therapy education programs haven’t just grown in number; they’ve also grown in complexity. Educational standards in the field have progressed from certificate programs, to baccalaureate degrees, to master’s degrees, and now to doctoral degrees. And today’s physical therapists are engaged in cutting-edge research into aspects of physical therapy and rehabilitation that are growing the profession even further.

“Any profession is driven by its capacity to drive new knowledge within its field,” Dr. Shields says. “When I wrote my first National Institutes of Health (NIH) grant 25 years ago, there were only a handful of physical therapists competing for NIH resources to advance the science of rehabilitation. Today, virtually every institution has highly funded physical therapists who are advancing the field of rehabilitation.”

The Challenges of Physical Therapy

Data from the US Department of Health and Human Services (DHS) shows that over 80 percent of American adults and adolescents don’t get enough physical activity. That results in an estimated $117 billion in added healthcare costs in the US and leads to a reduced quality of life for millions of Americans.

Advancements in consumer technology have been a double-edged sword: on one hand, technology has made it easy for the average person to track their movements and exercise; on the other, it’s also made the average person more sedentary. Physical therapists can (and do) help change behaviors and build healthy lifestyles, but it requires an equal level of commitment from their clients.

“We are a society that generally likes to only have to swallow a pill to get our health benefits—exercise is not a pill,” Dr. Shields says. “And when we prescribe exercise, we’re rarely prescribing for just a day, a week, or a month. The challenge is to change a behavior. But once you change a behavior to a commitment of a lifestyle that then incorporates these principles, that’s extremely rewarding.”

Physical activity and exercise are, among other things, forms of preventive healthcare. By setting habits early, people can reduce the risk of chronic disease and future injury. Unfortunately, reimbursement systems haven’t fully adapted to properly incentivize this.

“It’s much easier to get reimbursed for treating someone with a chronic disease than it is when you’re preparing someone to prevent a chronic disease,” Dr. Shields says. “But we always advocate for supporting healthcare that supports prevention.”

Funding has also fallen short in other key areas. In the past, the length of stay for inpatient rehabilitation from a spinal cord injury was six months; today it’s 30 to 60 days.

Physical therapists are advocating for more time with their clients so that they can properly train them with the skills they need to become more independent and avoid secondary complications in the future. Physical therapists are also advocating for more evidence-based research that can be implemented into the profession as a whole.

“APTA has led advocacy campaigns, supported research, and driven the development of highly-accredited academic programs where evidence is the focus, and not just procedures or technique,” Dr. Shields says. “The centennial really implanted the importance of being a part of the organization, and working together as we enter the next 100 years of the profession.”

The Future of Physical Therapy

Physical therapy is continuing to evolve, and new best practices are emerging around the intersection between population health and personalized care. While the general sentiment in the public and in the health professions is that exercise is good, exercise is not a monolith. The future of physical therapy is more precise and more personalized, and it takes into account the trends of population health as well as individual factors like epigenetics.

“If you’re prescribing for balance, that’s very different from prescribing for insulin sensitivity, or prescribing for influencing osteoporosis and bone health,” Dr. Shields says. “There are very precise prescriptions, and these variances are important for us to appreciate as we move forward.”

Physical therapists will benefit from having not just an understanding of exercise prescription, but also how to turn on signaling pathways in the human body to lead to improved adaptations, whether in someone who’s had an injury or someone who hasn’t. These skills would be critical in a future where physical therapists lead the way in primary care as the service of choice for entering a healthcare system, working preventatively and proactively with their clients.

The pace of change in physical therapy is continuing to accelerate. The Bureau of Labor Statistics (BLS 2021) projects that openings for physical therapists will grow 21 percent nationally between 2020 and 2030, a rate that’s more than double the national average for all professions. That amounts to an estimated 49,100 new physical therapy jobs. Their headquarters won’t be a New York City steakhouse, but instead a newly opened APTA Centennial Center in Alexandria, Virginia.

“The centennial allowed us to really reflect on where we’ve been, where we are today, and where we will be 100 years from now,” Dr. Shields says. “Across the country, whether you look in private practice, or in rehabilitation, or in hospital settings, the growth in the field of physical therapy is just phenomenal.”

Resources for National Physical Therapy Awareness Month

To learn more about the field of physical therapy, and to connect with the broader physical therapy community, check out some of the resources below.

  • American Physical Therapy Association (APTA): For 100 years, APTA has been building a community that advances the profession of physical therapy to improve the health of society. They have dedicated resource hubs for students and early-career PTs and PTAs.
  • ChoosePT: The official consumer information website of APTA, ChoosePT educates the public and patients on the field of physical therapy.
  • Physical Activity Guidelines for Americans: Published in 2019 by the US Department of Health and Human Services (DHS), the second edition of the Physical Activity Guidelines for Americans outlines the most current established research in physical activity.
Matt Zbrog

Matt Zbrog

Writer

Matt is a writer and researcher from Southern California. He’s been living abroad since 2016. Long spells in Eastern Europe, Southeast Asia, and Latin America have made the global mindset a core tenet of his perspective. From conceptual art in Los Angeles, to NGO work on the front lines of Eastern Ukraine, to counterculture protests in the Southern Caucasus, Matt’s writing subjects are all over the map, and so is he.

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