This April, tens of thousands of those in the medical community will be celebrated during Occupational Therapy Month. They work with patients in a variety of settings, from schools to home health, hospitals, outpatient clinics and more. Physical therapists work in the same capacities, and for many the lines between the role of occupational and physical therapy are blurred.”Physical and occupational therapists often work together as a team. For example, in a hospital, a doctor may recommend both. A physical therapist could work with a patient on their balance, gait and safety, while an occupational therapist works with a patient on increasing their independence with their self-care,” explained Schayla Axson, an occupational therapist at Summerville Medical Center.
While there can be a lot of overlap between the two medical professions, they often work independently from each other, depending on the patient’s needs and goals. They also both see a variety of problems, from injuries or surgeries to neurological problems to people who suffer from recurring pain or lack of motion.
“Occupational therapists look at the whole person and their injury or area of concern and help them learn to do functional things like bathing or dressing or adapt to a task or environment that is part of the patient’s daily routine. We call it ‘ADLs,’ the activities of daily living,”‘ she continued. “For example, if a patient fractured their wrist, we look at their limitations and what part of the healing process they’re in. We then work on improving their motion, strength and dexterity so they can use their hands functionally again with tasks like writing, gripping, opening container and lifting.”
Axson said the biggest goal for occupational therapists is to help patients be functional and as independent as possible in their daily routine, whether it’s being able to get up to use the restroom or to use adaptive equipment like a reacher or a shoehorn for dressing or to be able to use their upper extremities to complete additional ADL tasks.
“One of the joys of being an occupational therapist is being able to work with a patient that may start with severe deficits and through therapy is able to regain their independence. For example, after a stroke, a patient may lose strength and control of their arm, but after working with occupational therapy, that patient is able to use their arm to do their own hair, brush their teeth and put clothing on without anyone having to help them,” she said.
Similarly, one of the main goals of physical therapists is to increase mobility and functionality.
Dr. Ed Klixbull, a physical therapist, board-certified orthopedic clinical specialist, certified strength and conditioning specialist and regional clinic manager for CORA Physical Therapy, agreed there is overlap and explained that the end goals of occupational and physical therapies can be different.
“An occupational therapist may look at physical limitation from an adaptive standpoint as well; if someone doesn’t have the capacity to hold a spoon, they help the patient adapt to it. A physical therapist assesses the patient’s mechanical ability to make the motion of holding a spoon, then devises a plan of care utilizing manual joint and soft tissue mobilization techniques, range of motion exercises and strengthening to facilitate the reproduction of normalized motion to return to function,” Dr. Klixbull said.
He went on to illustrate that there is substantial overlap in the two professions regarding specializing in patients with hand to elbow issues but that the lower extremities are a focus of many physical therapists, but very rarely a focus for occupational therapists.
In addition to the traditional moving, stretching and strengthening exercises used by occupational and physical therapists, other methods are gaining popularity in the world of therapy.
Dr. Jason St. Clair, a physical therapist, board-certified orthopedic clinical specialist and owner of RISE Rehabilitation, often uses a technique called dry needling to treat patients with musculoskeletal conditions such as arthritis, tendonitis and chronic pain. When repetitive use or trauma causes an injury, damaged muscle tissue will go into a protective tensions state or contracture. This can lead to pain and limit the patient’s ability to function properly.
“The procedure consists of solid filament needles being inserted into the skin and underlying tissue, which disrupts pain sensory pathways and relaxes the area of injury,” Dr. St. Clair explained. “A common question is if it is like acupuncture, but the theory is derived from Western medicine principles and research. The only similarity is the use of a needle.”
Dry needling is not a new concept, but has grown in popularity in the past decade as more research supports its benefits. It helps common conditions like neck and back pain, headaches, knee and hip pain.
If you experience chronic pain or have an injury that requires the help of a physical or occupational therapist, some therapists will treat you for a period of time without requiring a referral, depending on their level of comfort and training regarding your condition, or you can ask your physician to refer you to the proper specialist.
By Anne Toole