Orthopedic (orthopaedic) physical therapy focuses on the treatment and rehabilitation of the orthopedic system, which includes muscles, bones, tendons, joints, and ligaments.
Orthopedic conditions often cause pain and swelling, along with decreased mobility, strength, and range of motion. This means the goal of physical therapy in orthopedics is to improve functional capacity, reduce symptoms, decrease pain, and improve the overall well being of patients.
What Orthopedic Physical Therapy Encompasses
Orthopedic physical therapy involves the evaluation, treatment, and management of conditions associated with the musculoskeletal (bones and muscles) system.
Musculoskeletal conditions treated through orthopedic physical therapy are vast and may include fractures, strains/sprains, ligament/tendon/muscle tears, joint/muscle/tendon inflammation, arthritis, and joint pain.
This type of physical therapy also includes post-surgery therapy for muscle and joint reconstruction and joint replacements.
Just a few of the musculoskeletal conditions treated through orthopedic physical therapy include:
- Osteoarthritis
- Osteoporosis
- Fibromyalgia
- TMJ dysfunction
- Tennis elbow
- Carpel tunnel syndrome
- Disc herniation
- ACL tears
- Rotator cuff tears
- Achilles’ tendonitis
- Plantar fasciitis
Physical Therapy Treatments for Orthopedic Conditions
Physical therapist assistants in orthopedics—working under the guidance and supervision of licensed physical therapists—treat patients using a variety of treatments and modalities.
They are often part of a larger team of medical professionals that make up the musculoskeletal rehabilitation team. This team may include:
- Orthopedic surgeons
- Neurologists/neurosurgeons
- Internists
- Registered dieticians
- Occupational therapists
- Exercise physiologists
- Recreation therapists
The types of orthopedic physical therapy provided by physical therapist assistants include:
- Manual therapy
- Mobilization
- Myofascial release
- Soft tissue mobilization
- Craniosacral therapy
- Manual therapy
- Strengthening
- Therapeutic exercises
- Stabilization exercises
- Strengthening
- Range of motion
- Stretching
- Range of motion
- Education
This type of physical therapy also includes the use of modalities, such as:
- E-stimulation
- Ultrasound
- Heat/ice
- Cold laser
Orthopedic Manual Physical Therapy
One of the most common types of orthopedic physical therapy is manual physical therapy, a hands-on treatment that involves:
- Soft tissue techniques
- Resistance therapy
- Passive movements of the affected body part
- Muscle stretching
- Joint mobilization and manipulation
Each type of manual treatment accomplishes specific goals. For example, physical therapist assistants utilize resistance therapy to encourage muscle activation and timing, while soft tissues techniques improve the mobility and function of tissue and muscles.
Physical therapist assistants use manual physical therapy to treat both acute and chronic conditions of the neck, back, arms, legs, and head. Physical therapist assistants implement manual treatments through an exercise and movement re-education program. In the presence of soft tissue and joint restrictions, physical therapist assistants often incorporate additional, hands-on therapies to improve mobility, reduce pain, and restore the normal function of the soft tissues and joints.
Manual physical therapy differs from other types of manipulation, such as massage, chiropractic, and osteopathic therapies due to the assessment process behind manual therapy treatment. Physical therapist assistants in orthopedics carefully examine a patient’s movement patterns and implement a continuous cycle of assessment, treatment, re-assessment, and further treatment based on the patient’s response to the therapy.
Training, Education, and Certification Options for PTAs in Orthopedics
Physical therapist assistants must become state licensed to practice, which requires completing a physical therapist assisting associate’s degree program that has been accredited through the Commission on Accreditation in Physical Therapy Education (CAPTE) and passing the PTA National Physical Therapy Examination.
Though the structure of CAPTE-accredited physical therapist assisting associate’s degree programs do not allow students to specialize in a specific area, students do have the ability to select electives that may focus more on a specific specialty like orthopedics.
The bulk of a physical therapist assistant’s specialized orthopedic training occurs while working alongside a licensed physical therapist in an orthopedic setting. Many of these physical therapists hold specialist certification in orthopaedics through the American Board of Physical Therapy Specialties.
Some of the settings in which physical therapist assistants in orthopedics may practice include:
- Hospitals (orthopedic, surgical units)
- Rehabilitation centers
- Nursing home/assisted living facilities
- Physical therapy practices
- Sports medicine/athletic training centers
- Homecare
Experienced physical therapist assistants in orthopedics often choose to earn the PTA Recognition of Advanced Proficiency in musculoskeletal physical therapy through the American Physical Therapy Association. The PTA Recognition of Advanced Proficiency is reserved for physical therapist assistants who have earned advanced proficiency through education, experience, and leadership.
Many physical therapist assistants in orthopedics also apply for membership in the Orthopaedic Section of the American Physical Therapy Association as a way to remain current in industry developments, take continuing education courses related to the practice of orthopedic physical therapy, and network with other professionals in the industry.