The New Role of a Physical Therapist
The way we age has changed, and so has the role of physical therapy. Here’s an expert take on the new roles, responsibilities, and effects PT professionals will have on our society from now on.
In the United States, about 10,000 people turn 65 every day, and one in five Americans will be 65 or older by 2030. Globally, the number of people age 60 and over is projected to leap from about 900 million in 2015 to 2 billion by 2050, according to the World Health Organization. Even more alarming is that the most vulnerable and care needy group of 85 and older is projected to quadruple in the following decades! As we face an increasingly aging population, the demand for quality senior care will be paramount. But what will physical therapy “treat” in the future?
While today physical therapy is most associated with the rehabilitation of an injury, or after a surgical procedure, some experts believe that as we develop more precision treatments, cures, and preventive medicine techniques, seniors would not seek a PT to work on functional limitations, but, rather, to extend vitality – even to the point of achieving goals they have had all their lives, such as running a marathon.
Sitting by grandma in a rocking chair reading a book may still take place, but probably after she played pickleball and maybe had yoga that morning. Seniors are more active than ever, healthier than ever, and are able to compete in recreational sports and activities at a very advanced age. We have seniors doing all this on repaired (or replaced) hips, knees, and ankles. We have tennis racquets and golf clubs swung after wrist, elbow, or shoulder surgeries regularly now.
This year only, we had 12,000 athletes ages 50 and over who competed in 21 medal sports at the National Senior Games in Fort Lauderdale, Florida. According to the International Health, Racquet & Sportsclub Association, the number of people 65 years and older going to health clubs has increased by 34% since 2010. A study from the Journal of Medical Internet Research that used exercise app tracking data for 5,300 people found that exercise habits of young to middle-aged people declined during the pandemic – while those of people 65 and older ramped up.
Looking at these numbers, I strongly believe the most commonplace, and effective role of a physical therapist, will essentially be a personal trainer for this demographic. Unfortunately, there is much more risk associated with exercise, and playing sports at an advanced age. This is where we come in, as experts in the field. Physical therapists prescribe exercises based on precise physiological, evidence-based, data-driven science. Everything is a personal, case-by-case, patient-to-patient decision. Dealing with a population at much greater risk of injury, the quality and expertise of prescribed exercise and health programs must be of the highest quality.
People over 50 years old come in all shapes, sizes, and fitness levels, but there’s one thing that applies to almost all seniors: they do not need to be jumping on and off boxes or doing jumping lunge squats. Why? The reason is obvious: avoid putting undue stress on our joints and focus instead on fitness that enhances their day-to-day lives. At this time of life, the primary goal of working out is no longer to look good in a bathing suit on spring break. Instead, the focus tends to lean more toward becoming stronger and more flexible while increasing stamina and endurance.
We need the strength and flexibility to pick up our grandchildren without straining our backs. We need the conditioning to be able to carry grocery bags up a flight of stairs without getting winded. If we go on a trip, we want to be able to keep up with the tour group, and not fall behind. When we put focus on getting or staying in shape as a senior, we’re thinking less about short-term gratification and more about long-term success.
This isn’t to say I haven’t seen and trained several seniors who have more power than some 20-year-olds. At the end of the day, when I train a senior, I make sure to take the time to demonstrate proper modifications that can give my client the same results without the strain. One program does not fit all and we must pay attention to past injuries and work together to overcome obstacles standing in the way of a better life. We shouldn’t train with the intensity of a 20-year-old; we should train with the durability of a senior.
Covid-19 from the very outset produced the worst of times for older adults. Not only were seniors suddenly isolated from family but they were also isolated from each other and from their care providers of all types, notably physicians. Gaps in connectivity for seniors came into focus, including a lack of broadband access at home and in senior living, plus a lack of appropriate technology and training for older adults. In the last two years, tech usage among older adults has skyrocketed. New research from AARP found that more older adults (44%) view tech more positively as a way to stay connected than they did before the pandemic. In addition, 4 out of 5 adults age 50+ rely on technology to stay connected and in touch with family, friends, and health care providers.
While there is no arguing that a physical assessment will always be done best in person, the clarity of video calls helps with accuracy when performing this remotely. Online training for seniors especially, offers a great time-saving, cost-effective, and safe manner in which to continue their fitness goals. After the initial session, clients quickly realize we can achieve high intensity with just a few bands. Also, we can use towels, empty water jugs, pillows, bookbags, broomsticks, and a variety of household items as resistance tools. Plus, the convenience of avoiding driving to, and from the gym, the pleasure of immediately jumping into your own shower, and the satisfaction of making a fresh, post-workout smoothie at home.
Seniors who benefit from this online model of training, also benefit from working directly with therapists, as cash-based services usually cost less per session. Most therapists who are
frustrated with health insurers — specifically the reimbursement process and appealing claim disavowals — have started to consider progressing their practices from insurance-based to all-cash. When conducting studies, many physical therapists quote that 25-30% of their time is spent on administrative duties directly as a result of insurance. Many therapists are therefore very happy to reduce rates - which were inflated because of these inefficiencies, to begin with - as a trade-off for not dealing with this system, and putting time into their patients.
That said, there is no better time to be a physical therapist, or to hire one. By 2040, the market for senior healthcare will absolutely dominate the health & fitness industry. As we face more and more challenges in society, coupled with technology improving yearly, remote online training will become the normal method for healthcare and physical fitness. And it will play an essential role in designing a world we want to age into.