Physicians like Hippocrates and later Galenus are believed to have been the first practitioners of physical therapy, advocating massage,manual therapy techniques and hydrotherapy to treat people in 460 BC. After the development of orthopedics in the eighteenth century, machines like the Gymnasticon were developed to treat gout and similar diseases by systematic exercise of the joints, similar to later developments in physical therapy.
The earliest documented origins of physiotherapy (physical therapy) as a professional group date back to Per Henrik Ling, “Father of Swedish Gymnastics,” who founded the Royal Central Institute of Gymnastics (RCIG) in 1813 for massage, manipulation, and exercise. The Swedish word for physiotherapist (physical therapist) is “sjukgymnast” = “sick-gymnast.” In 1887, physiotherapist’s (physical therapist’s) were given official registration by Sweden’s National Board of Health and Welfare. Other countries soon followed. In 1894 four nurses in Great Britain formed the Chartered Society of Physiotherapy. The School of Physiotherapy at the University of Otago in New Zealand in 1913, and the United States’ 1914 Reed College in Portland, Oregon, which graduated “reconstruction aides.”
Modern physiotherapy (physical therapy) was established in Britain towards the end of the 19th century. Soon following American orthopedic surgeons began treating children with disabilities and began employing women trained in physical education, massage, and remedial exercise. These treatments were applied and promoted further during the Polio outbreak of 1916. During the First World War women were recruited to work with and restore physical function to injured soldiers, and the field of physiotherapy (physical therapy) was institutionalized. In 1918 the term “Reconstruction Aide” was used to refer to individuals practicing physiotherapy (physical therapy). The first school of physiotherapy (physical therapy) was established at Walter Reed Army Hospital in Washtington D.C. following the outbreak of World War I. Research catalyzed the physiotherapy (physical therapy) movement. The first physical therapy research was published in the United States in March 1921 in “The PT Review.” In the same year, Mary McMillan organized the Physical Therapy Association (now called the American Physical Therapy Association (APTA). In 1924, the Georgia Warm Springs Foundation promoted the field by touting physical therapy as a treatment for polio.
Treatment through the 1940s primarily consisted of exercise, massage, and traction. Manipulative procedures to the spine and extremity joints began to be practiced, especially in the British Commonwealth countries, in the early 1950s. Later that decade, physiotherapist’s (physical therapist’s) started to move beyond hospital-based practice to outpatient orthopedic clinics, public schools, colleges/universities, geriatric settings (skilled nursing facilities), rehabilitation centers and medical centers. In 1921 in the physiotherapist’s (physical therapist’s) within the United States formed the first professional association called the American Women’s Physical Therapeutic Association. This gave birth to what is known today as the American Physical Therapy Association (APTA), and currently represents approximately 76,000 members throughout the United States. The American Physical Therapy Association defines physical therapy as: “clinical applications in the restoration, maintenance, and promotion of optimal physical function.”
Specialization for physiotherapy (physical therapy) in the U.S. occurred in 1974, with the Orthopaedic Section of the American Physical Therapy Association being formed for those physiotherapist’s (physical therapist’s) specializing in orthopaedics. In the same year, the International Federation of Orthopaedic Manipulative Physical Therapists was formed, which has ever since played an important role in advancing manual therapy worldwide.
Specialty areas
A common misconception is that physiotherapists only deal with injuries to backs, necks, joints, muscles and other ‘sports’ type injuries. While many physios certainly do treat these types of conditions, there are other areas in which physiotherapists are trained and can help you. Because the body of knowledge of physical therapy is quite large, some PTs specialize in a specific clinical area. While there are many different types of physical therapy, the American Board of Physical Therapy Specialties list eight specialist certifications
Cardiovascular & pulmonary
Cardiovascular and pulmonary rehabilitation respiratory practitioners and physical therapists treat a wide variety of individuals with cardiopulmonary disorders or those who have had cardiac or pulmonary surgery. Primary goals of this specialty include increasing endurance and functional independence. Manual therapy is used in this field to assist in clearing lung secretions experienced with cystic fibrosis. Disorders, including heart attacks, post coronary bypass surgery, chronic obstructive pulmonary disease, and pulmonary fibrosis, treatments can benefit from cardiovascular and pulmonary specialized physical therapists.
Clinical electrophysiology This specialty area encompasses electrotherapy/physical agents, electrophysiological evaluation (EMG/NCV), physical agents, and wound management
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Geriatric
Geriatric physical therapy covers a wide area of issues concerning people as they go through normal adult aging but is usually focused on the older adult. There are many conditions that affect many people as they grow older and include but are not limited to the following: arthritis, osteoporosis, cancer, Alzheimer’s disease, hip and joint replacement, balance disorders, incontinence, etc. Geriatric physical therapists specialize in treating older adults Integumentary Integumentary (treatment of conditions involving the skin and related organs). Common conditions managed include wounds and burns. Physical therapists utilize surgical instruments, mechanical lavage, dressings and topical agents to debride necrotic tissue and promote tissue healing. Other commonly used interventions include exercise, edema control, splinting, and compression garments.
Neurological
Neurological physical therapy is a field focused on working with individuals who have a neurological disorder or disease. These include Alzheimer’s disease, Charcot-Marie-Tooth disease (CMT),ALS, brain injury, cerebral palsy,l.g.b.syndrome, multiple sclerosis, Parkinson’s disease, spinal cord injury, and stroke. Common impairments associated with neurologic conditions include impairments of vision, balance, ambulation, activities of daily living, movement, muscle strength and loss of functional independence. Physiotherapy can address many of these impairments and aid in restoring and maintaining function, slowing disease progression, and improving quality of life. In layman’s terms, neurological massage is directed toward correcting and healing out-of-normative body systems, unlike traditional massages, such as Swedish massage, that are directed toward comfort and relaxation.
Orthopedic
Orthopedic physical therapists diagnose, manage, and treat disorders and injuries of the musculoskeletal system including rehabilitation after orthopedic surgery. This specialty of physical therapy is most often found in the out-patient clinical setting. Orthopedic therapists are trained in the treatment of post-operative orthopedic procedures, fractures, acute sports injuries, arthritis, sprains, strains, back and neck pain, spinal conditions, and amputations. Joint and spine mobilization/manipulation, dry needling, therapeutic exercise, neuromuscular reeducation, hot/cold packs, and electrical muscle stimulation (e.g., cryotherapy, iontophoresis,electrotherapy) are modalities often used to expedite recovery in the orthopedic setting. Additionally, an emerging adjunct to diagnosis and treatment is the use of sonographyfor diagnosis and to guide treatments such as muscle retraining. Those who have suffered injury or disease affecting the muscles, bones, ligaments, or tendons will benefit from assessment by a physical therapist specialized in orthopedics.
Pediatric
Pediatric physical therapy assists in early detection of health problems and uses a wide variety of modalities to treat disorders in the pediatric population. These therapists are specialized in the diagnosis, treatment, and management of infants, children, and adolescents with a variety of congenital, developmental, neuromuscular, skeletal, or acquired disorders/diseases. Treatments focus on improving gross and fine motor skills, balance and coordination, strength and endurance as well as cognitive and sensory processing/integration. Children with developmental delays, cerebral palsy, spina bifida, or torticollis may be treated by pediatric physical therapists.
Sports
Physical therapists can be involved in the care of athletes from recreational to professional and Olympians. This area of practice includes athletic injury management, including acute care, treatment and rehabilitation, prevention, and education. Physical therapists are also active in sports medicine programs. Physical therapists who work for professional sport teams often have this specialized certification.
Women’s health
Women’s health physical therapy addresses women’s issues related to child birth, and post-partum. These conditions include lymphedema, osteoporosis, pelvic pain, prenatal and post partum periods, and urinary incontinence.