Once focused primarily on recovering wounded soldiers, the physical therapy profession has evolved dramatically over the last 100 years. Moving from the battleground to patients’ homes, hospitals, clinics, sports arenas, and even phones (like at TailorCare), physical therapists are now recognized as essential rehabilitation providers and respected healthcare team members.
This evolution progressed through advancements in education and training, medical breakthroughs and a growing recognition that movement is essential in preventing and managing disease. Let’s examine how this discipline evolved from an accessory to a central function of clinical models like TailorCare.
The Early Days: A Profession Transformed by War
While we can trace the origins of several physical therapy techniques to the times of Hippocrates in 460 B.C., a significant driver in formalizing physical therapy was the need for rehabilitation for injured soldiers returning home from World War I. At this time, reconstruction aides, civilian women who received on-the-job training in techniques such as therapeutic exercise, massage, and electrotherapy, assisted surgeons and provided rehabilitation care.
The Turning Point: Advancements in Research and Education
After World War II, the management of veterans with head injuries, amputations, and other complex traumas challenged the healthcare system. In parallel, widespread cigarette use contributed to the rising prevalence of strokes and heart disease. Standard policies today, such as car seat belts and occupational safety measures like steel-toed boots, did not yet exist. The result was far more dangerous conditions for people in and out of work, driving demand for new methods and approaches to rehabilitate injuries.
This need led to an impressive increase in rehabilitation research during the 1950s and 60s, which established the effectiveness of physical therapist intervention in treating a wide range of conditions. The American Physical Therapy Association developed a standardized competency examination to ensure physical therapists could safely and appropriately treat a wide range of conditions in practice. It also encouraged the growth of state licensure. By the end of the 1950s, 90% of states had licensure for physical therapists after completing a bachelor’s degree in physical therapy.
At this time, physical therapists used standardized techniques to evaluate strength and range of motion, allowing PTs to assess the extent of patient impairments and document patient progress over time in response to treatment. Combined with policy enactments such as Medicare and Medicaid programs and Social Security amendments, physical therapists began to bill for patient treatment independently.
These events served to shift perception and help establish physical therapists as musculoskeletal experts capable of treating conditions autonomously.
The Modern Era: Becoming a Doctoring Profession
By the 1990s, physical therapy education programs shifted to a Master’s degree. By the late 2000s, the Doctor of Physical Therapy (DPT) degree became the standard entry-level program for physical therapists. The recognition that managing more complex patients requires greater training and clinical exposure drove this educational advancement, ensuring new professionals can adequately navigate the complex healthcare system.
Today’s DPT curriculums are rigorous, combining advanced coursework in anatomy, physiology, biomechanics, and neuroscience with extensive research and clinical experience to equip physical therapists with patient management skills to treat movement disorders across the lifespan. Post-graduation, many physical therapists embark on residency and fellowship training programs to develop their skills in a specialty area of physical therapy practice. There are ten specialty areas of physical therapy practice where PTs can be board-certified, and 434 residency and 45 fellowship programs nationwide.
The Importance of Physical Therapists on the Healthcare Team
As healthcare continues trying to achieve the quadruple aim, physical therapists are well-positioned to contribute significantly to these efforts. Physical therapists can improve patient outcomes cost-effectively and are the experts in the movement system (the integration of body systems to generate body movement) who can readily address the physical activity needs of people living with disabilities and chronic conditions.
With technological advancements like telehealth, virtual reality, and wearable devices, physical therapists can reach more people and tailor care to patient needs. Furthermore, the growing recognition of preventive care and wellness broadens the role of physical therapists beyond traditional rehabilitation, enabling them to help individuals achieve and sustain optimal health outcomes.
The Future of Physical Therapists in Healthcare
Physical therapists are expanding their role beyond traditional responsibilities and are increasingly serving as care navigators, leveraging their expertise to guide patients through complex healthcare pathways. What sets TailorCare apart from other musculoskeletal-focused organizations is our understanding of, and deep appreciation for, PTs’ role in supporting patients and directing them to the right care for their particular needs. Their comprehensive experience and education are central to our clinical model, with PTs using their expertise and training to ensure patients receive the right care at the right time. This approach delivers a seamless, high-quality experience while improving outcomes.
As the physical therapy profession continues to evolve, its expanding role in guiding patients through complex healthcare journeys reaffirms its place as an essential and trusted pillar in modern healthcare.
Dr. Danilovich is the Director of Clinical Strategy and Policy at TailorCare. Prior to joining TailorCare, she led the Schanfield Research Institute and served on the faculty at Northwestern University’s Feinberg School of Medicine, where she was the founding director of the dual-degree program in physical therapy and public health. She also directed a research lab on health promotion interventions for aging populations. As a clinical researcher and physical therapist, her work has been funded by the American Physical Therapy Association, the Patient-Centered Outcomes Research Institute, and the National Institutes of Health. Dr. Danilovich has published over 30 peer-reviewed manuscripts and has lectured internationally on geriatric physical therapy.