Physiotherapists - What They Do

Physiotherapists assess patients and plan and carry out individually designed treatment programs to maintain, improve or restore physical functioning and mobility, alleviate pain and prevent physical dysfunction in patients. They are employed in hospitals, clinics, industry, sports organizations, rehabilitation centres and extended care facilities, or they may work in private practice.

Job duties

This group performs some or all of the following duties:

Assess patients' physical abilities through evaluative procedures such as functional ability tests
Establish treatment goals with patients based on physical diagnoses
Plan and implement programs of physiotherapy including therapeutic exercise, manipulations, massage, education, the use of electro-therapeutic and other mechanical equipment and hydrotherapy
Evaluate effectiveness of treatment plans and modify accordingly
Provide advice on exercise and strategies to implement at home to enhance and or maintain treatment
Communicate with referring physician and other health care professionals regarding patients' problems, needs and progress
Maintain clinical and statistical records and confer with other health care professionals
Develop and implement health promotion programs for patients, staff and the community
May conduct research in physiotherapy
May provide consulting or education services.
Physiotherapists may focus their practice in particular clinical areas such as neurology, oncology, rheumatology, orthopedics, obstetrics, pediatrics, geriatrics, in the treatment of patients with cardiovascular and cardiopulmonary disorders, burns or sports injuries or in the field of ergonomics.

Job titles

registered physiotherapist
research physiotherapist
physical therapist
physiotherapist

Employment Requirements

This is what you typically need for the job:

A university degree in physiotherapy and a period of supervised practical training are required.
A licence or registration with a regulatory body is required to practise physiotherapy in all provinces.
Completion of the Physiotherapy National Exam, administered by the Alliance of Physiotherapy Regulatory Boards, may be required.

Essential Skills

Reading

Read short instructions on equipment labels. For example, they may read operating instructions on the labels of ultrasound and electrotherapy equipment. (1)
Read text entries in forms. For example, they may read descriptions of accidents involving patients in insurance claim forms. They may also read patients' comments about patients' health concerns in intake forms. (2)
Read e-mail messages from co-workers and letters from colleagues. For example, they may read about meeting arrangements and schedule changes in e-mail messages from co-workers. They may also read letters from referring doctors who describe patients' injuries and from workers' compensation board officials who confirm support for the payment of treatments. (2)
Read trade magazines, brochures and professional associations' newsletters to stay abreast of technological advances, legislative changes and other matters affecting their practices. For example, a physiotherapist may read Physio-Québec to learn about new software to prepare personalized exercise programs for patients and to find information on an upcoming conference on risk management in physiotherapy. (3)
Read textbooks and academic journals to expand their knowledge of physical functions, dysfunctions and disorders of the musculo-skeletal, nervous, cardiovascular and cardiopulmonary systems. They may also read journals to learn about the results of research in neurology, oncology, rheumatology, orthopedics, obstetrics, pediatrics, geriatrics and other physiotherapy practice areas. For example, they may read the Introduction to Problem Solving in Biomechanics to deepen their understanding of the mathematics and physics involved in knee movements, weight loads and joint sharing. They may read an article in the Archives of Internal Medicine about German trials showing the effectiveness of acupuncture techniques in the treatment of back pain. They may also read an arthritis researchers' study published in Physiotherapy Canada about access barriers to physiotherapy services. (4)

Document use

Locate data on product and equipment labels. For example, they may scan labels on electrotherapy, hydrotherapy and other equipment for manufacturers' names and model numbers. They may scan labels on patients' medications for drug names, dosages and renewal dates. (1)
Locate data in lists, tables and schedules. For example, they may scan bibliographies at the end of journal articles to identify other articles relevant to their practice areas. They may scan their daily schedules to locate the times and locations of their appointments with patients. They may also skim calendars prepared by professional societies, universities, hospitals and other organizations to locate the dates, costs and locations of conferences, seminars, symposia, workshops and courses they wish to attend. (2)
Enter data into tables and schedules. For example, physiotherapists in hospitals, rehabilitation centres, nursing homes and residential care facilities may enter patients' names, appointment times, activity codes and dates into time log tables. They may also enter their assessments of patients' abilities to stand unsupported, sit unsupported, reach forward, turn around and perform other movements into Berg Balance Scale tables and other test score sheets. (2)
Locate data in treatment referral, patient intake and consent to treatment forms, physiotherapy claims, medical histories, permissions to release health information and other entry forms. For example, a physiotherapist may review an intake form completed by a patient to verify access to insurance and locate the names of the employer, insurance company provider and insured person. (2)
Locate data in graphs. For example, they may locate data in graphs that show maximum torque produced at various knee angles. (2)
Complete entry forms such as insurance claims, treatment extension requests, mobility, spinal and other physiotherapy assessments, discharge reports, purchase orders, invoices and receipts. They may have to combine data from several sources to complete such forms. For example, a physiotherapist in a rehabilitation centre may complete a physiotherapy assessment form to document the outcomes of a patient's initial evaluation. The physiotherapist may enter the patient's name, address, age, social and mental status and the names of occupational therapists, social workers and nurses concurrently helping the patient. (3)
Locate data in radiographs, diagnostic images, sketches and pictures. For example, a physiotherapist may scan a patient's radiographs to locate pins in a bone that restrict mobility. The physiotherapist may also scan a surgeon's sketch to identify the location of a surgical procedure performed on a patient's knee. (3)

Writing

Write notes to record details of diagnoses and treatments. For example, they write notes in patients' files to record information about prescribed exercises, treatment procedures and responses to treatments. (1)
Write detailed text entries in forms. For example, a physiotherapist in a rehabilitation centre may write a lengthy description of a patient's joint stability, leg length discrepancy, posture and gait in a physical examination form. (2)
Write e-mail and letters to co-workers and colleagues. For example, they may write e-mail messages to co-workers to share information on new treatment approaches. They may write letters to referring doctors to outline the progress made by patients. They may also write letters to lawyers to offer opinions on patients' injuries and the extent to which they can carry out regular work activities. (2)
Write treatment and rehabilitation plans for patients suffering from dysfunctions and disorders of the musculo-skeletal, nervous, cardiovascular and cardiopulmonary systems. In these plans, they provide physiotherapy assessments of patients' conditions, identify goals to be reached by patients and define outcome measurement methods. They also describe detailed programs which may include therapeutic exercises, massages, manipulations, mobilizations, electro-therapy, hydro-therapy, acupuncture and other treatments. (3)
May write the text for newspapers, newsletters, leaflets, brochures and Internet sites to promote preventive health care and physiotherapy services. They must address key questions about the prevention and treatment of physical dysfunctions and disorders in an effective manner. They may have to gather, select and rewrite information from various sources for a mixed audience of patients, caregivers, health care professionals and representatives from community organizations. For example, a physiotherapist may write leaflets to warn mothers about jumpers, rollators and other equipment which may be detrimental to babies' physical development. A physiotherapy supervisor may write a newsletter article about the role of the physiotherapist as part of the preventative medical team. (4)
May write articles for trade publications, academic journals and conference proceedings. For example, a physiotherapist may write an article about the development of an evaluation grid for seniors' walking safety. The physiotherapist summarizes research protocols, outlines difficulties encountered in collecting data, discusses principles used to analyse data collected, presents results obtained and explains their significance. (5)

Numeracy

Money Math

Calculate and verify travel reimbursement amounts. For example, physiotherapists covering sporting events calculate reimbursements for use of personal vehicles at per kilometre rates and add amounts for accommodation, meals and other expenses. (2)
Calculate and verify purchase order and invoice amounts. For example, physiotherapists in private physiotherapy clinics and rehabilitation centres may calculate amounts to be invoiced to patients, workers' compensation boards and insurance companies. They may also calculate amounts for gym balls, weights and other clinic supplies, determine discounts and surcharges and add federal and provincial sales taxes. (3)

Scheduling, Budgeting & Accounting Math

May set their own appointment schedules. For example, physiotherapists in hospitals set their daily schedules so that they can meet patients at particular times. They need to adjust their schedules when some appointments take longer than expected. (2)
May set work schedules for co-workers. Physiotherapists with supervisory responsibilities may set work schedules for co-workers, taking into account workload indicators and the need to distribute job tasks equitably. They may have to adjust work schedules because of vacations and sick leave. For example, a physiotherapist may create work schedules for a private sports clinic employing six other physiotherapists, two osteopaths, two massage therapists, an acupuncturist, a secretary, a receptionist and an office administrator. (3)
May prepare and monitor operational budgets for physiotherapy offices and clinics. For example, physiotherapists in private practices have to ensure that expenditures incurred for salaries, rents, clinic and office supplies, utilities, and other expenses are fully covered by budgets. They may have to change budget line items because of unexpected events. (3)
May calculate amounts for payroll, utility and tax accounts. For example, physiotherapists in private clinics may calculate payroll amounts for other health professionals, receptionists, secretaries and office administrators. They multiply hours worked by hourly wage rates, calculate deductions for federal and provincial income taxes and contributions to pension plans and employment insurance. They may have to use different hourly wage rates for overtime and work on statutory holidays. (4)
May prepare and verify financial statements. For example, physiotherapists in private practices may prepare and verify monthly balance sheets, income and expense statements and statements of cash flows. (4)

Measurement and Calculation Math

Measure sizes and distances using common measuring tools. For example, a physiotherapist in a rehabilitation centre may use a tape to measure length discrepancy and swelling in a patient's leg. The therapist may also use a wheel to measure the distance walked by a patient and a stopwatch to measure walking time. (1)
Calculate durations, numbers of repetitions, loads and other specifications for exercise and therapy programs. For example, a physiotherapist in a sports clinic may calculate the resistance needed for an exercise and the number of repetitions at that weight to make an exercise effective for a patient. The therapist may also determine the duration of an exercise set using a ratio of exercise time to resting time. (2)
Take precise measurements using specialized tools. For example, they may use hand dynamometers, heart rate monitors, saturometers and goniometers to measure grip strengths, heart rates, oxygen saturations and joint ranges of motion respectively. (3)
Measure patients' physical abilities and risks using assessment instruments. For example, a physiotherapist may measure a senior's risk of falling using tools such as the Functional Reach Test, the Berg Balance Scale, the Timed Up and Go Test, the Dynamic Gait Index and the Tinetti Balance and Mobility Assessment. To obtain assessment results, the physiotherapist needs to perform several calculation steps. (3)

Data Analysis Math

May manage small inventories of clinic supplies. They establish desirable inventory levels and calculate turnover rates. They count inventories and calculate quantities needed to bring inventories to desirable levels. For example, self-employed physiotherapists may manage inventories of tapes, exercise bands, musculo-skeletal supports, braces, gym balls, weights and other supplies. (3)
Collect and analyse physical examination data and test results to assess patients' health, identify treatment options and monitor progress. For example, a physiotherapist working in the surgical respiratory unit of a hospital may collect and analyse measurements of a patient's pressure support, positive end-expiratory pressure, central venous pressure, arterial pressure and heart rate to assess overall health, develop a treatment plan and monitor progress. (3)
May collect, analyse and interpret physiotherapy research data. For example, a research physiotherapist may collect, analyse and interpret data to assess the effects of a physically-demanding environment on locomotion abilities after head traumas. (4)

Numerical Estimation

Estimate times needed to perform job duties, using past experience as a guide. For example, a physiotherapist may estimate the time required for an appointment with a patient by assessing the nature and complexity of treatment procedures to be performed. (1)
Estimate times needed by patients to achieve desired treatment outcomes. For example, a physiotherapist in a sports clinic may estimate the time required for an athlete to recover from an injury and return to competition. The therapist considers the severity of the injury and the athlete's health history and response to treatment. (2)

Oral communication

May speak to suppliers and purchasing officers to order and coordinate deliveries of products and equipment. For example, physiotherapists in hospitals, rehabilitation centres and extended care facilities may order tapes, exercise bands, musculo-skeletal supports, braces, gym balls and weights from purchasing officers. Physiotherapists in private clinics may coordinate the deliveries of hi-lo tables, parallel bars, treadmills, ergometers, ellipticals, weight stations and hydro-therapy equipment with suppliers. (1)
Give directions to co-workers and discuss ongoing work with them. For example, a physiotherapist may provide directions to an assistant for carrying out tasks such as removing hot packs from a patient's leg and operating ultrasound equipment. The therapist may also speak to co-workers about weekly work schedules, cancelled appointments and new patients needing assessments. (2)
Discuss patients' conditions, needs and progress with orthopedic surgeons, physiatrists, rheumatologists, neurologists, physical rehabilitation technicians, other physiotherapists and other health care professionals. For example, a physiotherapist may discuss a patient's occipital fracture, cerebral concussion and resulting chronic headaches, acuphen and loss of smell with the referring neurologist. The physiotherapist may report an alleviation of pain obtained through using the Gunn Intramuscular Stimulation technique and seek advice on what may be causing a metallic taste in the patient's mouth. (3)
Discuss medical histories, physical conditions, injuries and dysfunctions with patients and their families. They help patients identify reasonable treatment goals which may include the improvement of joint range of motion, strength, mobility, balance, endurance and respiratory function and the reduction of pain. They explain physical assessment results and discuss treatment options. They answer questions about treatment procedures and alleviate concerns. They also educate patients and their families about exercises and other measures to manage prevailing conditions and prevent recurrent injuries and dysfunctions. (3)
Make presentations to colleagues and community groups. For example, a physiotherapist in a sports clinic may deliver a presentation about injury prevention and proper medical care for athletes to a group of amateur coaches. A physiotherapist in a hospital may speak to a group of physiotherapy students about recommended exercises to improve mobility in patients suffering from Parkinson's disease. A physiotherapist in a geriatric institute may talk to a seniors' association about the prevention of falls. (4)

Thinking

Problem Solving

Are occasionally unable to perform treatments as planned because equipment is unavailable. For example, a physiotherapist may realize that no weight training station is available for a rehabilitation session with a patient. The therapist may teach free weight exercises to the patient until the station becomes available. (1)
Fnd that some patients miss appointments and others arrive late. They diplomatically remind such patients that they have busy schedules and cannot afford late arrivals and no-shows. Physiotherapists in private practices may also charge patients for missed appointments. (2)
Encounter patients who are difficult to treat. For example, they experience difficulties in getting some patients to carry out prescribed therapeutic exercises. They try different approaches in order to motivate patients to conform to treatment and rehabilitation plans. If they fail in their attempts, they may recommend that physiotherapy services be discontinued. (3)

Decision Making

May select workers for jobs such as receptionists, secretaries, office administrators and physiotherapy assistants. They consider individual academic backgrounds, skills, experiences, strengths, weaknesses and availabilities. (2)
May select suppliers for specific products and equipment. They take into account factors such as quality, specifications, prices and promised delivery dates. (2)
Select physiotherapy techniques, approaches and equipment to maintain, improve and restore physical functioning and autonomy, alleviate pain and prevent physical dysfunctions in patients. For example, they may select manipulative therapy to restore physical functioning in patients with sports injuries. They may prescribe exercises to improve patients' strength, mobility, coordination, flexibility and balance. They may also prescribe wheelchairs to increase the functional independence of paraplegic patients. They use professional knowledge and consider the treatment and rehabilitation objectives of patients. (3)

Critical Thinking

Evaluate the reasonableness of treatment goals suggested by patients. They consider each patient's overall health condition, age, lifestyle, motivation and physical abilities. (2)
Evaluate the performance of workers such as receptionists, secretaries, office administrators and physiotherapy assistants. For example, physiotherapists in university hospitals may assess the performance of student physiotherapists who assist them with job tasks. As part of these assessments, they determine the extent to which students have demonstrated the required technical and personal skills. They assign performance ratings to the skills observed and justify them in writing. They may recommend further supervised assignments at the conclusion of these performance evaluations. (3)
Evaluate patients' physical abilities and disabilities. They review patients' medical history forms, referral letters and treatment records. They clarify information about accidents, injuries, dysfunctions and pain by talking to patients and referring health care professionals. They conduct physical examinations and tests, measure patients' strength, mobility, coordination, flexibility, balance and other abilities and interpret results. They may also analyze radiographs, sonograms and other diagnostic images. As a consequence of these evaluations, they may recommend treatment and rehabilitation plans for patients. (3)
Evaluate the effectiveness of techniques, approaches and equipment used to treat patients' dysfunctions and disorders. They schedule regular visits with patients to monitor responses to treatments. They identify work still to be done to meet objectives identified in treatment and rehabilitation plans. For example, a physiotherapist may assess the effectiveness of specific exercises to improve mobility in a patient suffering from Parkinson's disease. The physiotherapist may also assess the effectiveness of the Gunn Intramuscular Stimulation technique to treat a patient with chronic pain of neuropathic origin. (3)

Job Task Planning and Organizing

Own Job Planning and Organizing

Physiotherapists plan and organize job tasks to meet the treatment needs of their patients. They set priorities and provide input into the day-to-day scheduling of patients' visits although their actual appointments are often booked by co-workers. Lack of equipment, appointment cancellations, emergencies and other unexpected events force them to frequently reorganize job tasks. (3)

Planning and Organizing for Others

Physiotherapists play a central role in organizing, planning and scheduling health services and contribute to long-term and strategic planning for their organizations. They may be responsible for assigning tasks to receptionists, secretaries, office administrators, physiotherapy assistants and other workers. (3)

Significant Use of Memory

May remember security codes to access computers, photocopiers and fax machines.
May remember activity codes to speed up time log entry and billing processes.
Remember patients' names and details about their medical histories, physical conditions, injuries and dysfunctions to save time, facilitate communication and show genuine interest.
Remember assessments and treatments performed during the day, specific problems encountered and recommendations discussed in order to complete patients' records at the end of the day.

Finding Information

Find information on patients' health by interviewing them, consulting referring health care professionals and searching medical history forms and treatment records. (2)
Find detailed information on products and equipment used in physiotherapy by contacting manufacturers and searching their websites. (2)
Find information on continuing education workshops and courses relevant to particular clinical areas by consulting co-workers and colleagues, searching trade magazines and newsletters, contacting professional societies, hospitals, universities and other training organizations and by searching their websites. (3)
Find information about unfamiliar dysfunctions, disorders and treatments of the musculo-skeletal, nervous, cardiovascular and cardiopulmonary systems by consulting co-workers and colleagues and searching a wide range of sources including textbooks, trade publications, physiotherapy and medical journals and the Internet. (4)

Digital technology

Use word processing. For example, they may write and edit text for treatment and rehabilitation plans, letters, leaflets, case study reports and journal articles using word processing programs such as Word. They generally use basic page and character formatting features. (2)
May use graphics software. For example, they may create slide shows using presentation software such as PowerPoint. In order to develop effective presentations for students, colleagues and community groups, they may import and place scanned images. (2)
May use databases. For example, they may enter and retrieve patients' appointment, assessment and treatment data from hospital and clinic databases. They may also search, display and print data from physiotherapy evidence databases such as PEDro. (2)
Use communications software. For example, they use e-mail programs such as Outlook to exchange e-mail messages and attachments with co-workers, colleagues and patients. (2)
Use the Internet. For example, they use Internet browsers such as Explorer to obtain information about physiotherapy treatments, training courses and equipment. They also use these browsers to access physiotherapy associations' websites and online journals and participate in discussion forums. (2)
May use other computer and software applications. For example, physiotherapists in private practices may assess their clinics' information technology needs and select electronic medical recording and clinical management systems such as ABELMed-Physio, PhysioGraphic and Pro DF. Using these systems, they may create patients' files, schedule and manage appointments, perform automatic billing and receipts' preparation, record assessments and treatments and generate reports. They may also select physiotherapy planning software such as Physiotec and PlaniPhysio-Action to prepare personalized exercise programs for patients. They may participate in configuring software and training co-workers who will be using it. (4)

Other Essential Skills:

Working with Others

Physiotherapists generally integrate and coordinate job tasks with other members of medical teams. Physiotherapists assigned to neurology and traumatology patients in a hospital may have to coordinate job tasks with neurologists, speech therapists, nurses, occupational therapists, social workers and neuropsychologists. Physiotherapists in a private clinic may direct, lead, supervise and train secretaries, office administrators and physiotherapy assistants to ensure the quality, efficiency and effectiveness of services. (3)

Continuous Learning

Continuous learning is an integral part of the job for physiotherapists. They are expected to expand their knowledge of physical functions, dysfunctions and disorders and to stay abreast of legislative changes, technological advances and research conducted in their physiotherapy practice areas. They acquire new learning by speaking with co-workers and colleagues, browsing the Internet and reading extensively. They also attend conferences, seminars, symposia, workshops and courses offered by professional societies and orders, universities, hospitals and other organizations. (4)