What’s the difference between PT and OT? I hear this question over and over. Most people have a general understanding of physical therapy, but what do occupational therapists do?
How do both these professions sometimes overlap, and how is OT in many cases more important than PT?
What’s the difference between OT and PT?
Someone once told me that physical therapists teach people how to walk and occupational therapists teach people how to dance. In other words, PTs focus on the physical needs to increase strength, range of motion, endurance, etc.
For OT, it’s a bit more complicated. OTs look at the person holistically and focus on treatments that are meaningful for the person.
For example, a patient who had a stroke might be weak on their left side and unable to walk. A PT may work on activities like getting out of bed, standing, and taking steps.
An OT is going to start with the basic self-care needs that might include grooming/hygiene, toilet transfers, dressing, and bathing.
OTs also may incorporate exercises as part of treatment, but when an activity is meaningful to the patient, it is easier for the patient to want to participate in therapy.
Think about the activity of standing. What does it means to stand for ten minutes? If you’re doing the activity to strengthen your legs, you might lose interest after a couple minutes.
What about if you’re watching TV? This may last a few more minutes, but soon you’re going to grab that bowl of buttery popcorn and veg out.
It all comes down to what motivates you and what is meaningful. That’s the core of occupational therapy. If you’re standing at the sink to brush your teeth, comb your hair, wash your face, or put on makeup, it suddenly is a better reason to stand for ten minutes.
Think for second about the difference between OT and PT in this example. Imagine you’re watching a basketball game. The players are running back and forth, jumping, dribbling, stealing, and shooting.
Now imagine they’re playing the same game without a basketball or hoop. Is it entertaining to watch? Is it meaningful for the players? No!
While the focus of physical therapy is exercise, occupational therapy focuses on what is meaningful, important, and engaging.
OTs work on physical conditioning as part of treatment, but the goal is to help people lead more independent and meaningful lives.
OTs also focus on cognition, vision, sensation, proprioception, emotional well-being, spirituality, sexual function, gait patterns, social participation, and sleep.
OTs help people learn how to manage medications, pay their bills, plan for retirement, or learn to drive. They empower others by teaching them skills to regain function and adapt to life challenges. They help them learn to live life to its fullest!
Why Occupational Therapy is more important than Physical Therapy?
I don’t mean to disrespect PT as a profession, but what does physical therapy do that occupational therapy doesn’t do?
According to the American Physical Therapy Association, “Physical therapists are movement experts who improve quality of life through prescribed exercise, hands-on care, and patient education… Physical therapists examine each person and then develops a treatment plan to improve their ability to move, reduce or manage pain, restore function, and prevent disability.”
You may think PTs teach patients how to ambulate and increase their gait pattern, but walking and gait are also part of the occupational therapy practice framework.
What about exercises? Physical therapists usually prescribe exercises to increase ROM, strength, endurance, and neuromuscular reeducation. They can assist in work hardening programs to help people return to work and train athletes to have better coordinated movements to reduce risk of injury.
OTs also focus on exercise. In fact, return to work programs and athlete training is more aligned with the OT profession than PT. It’s unfortunate that physical therapy has dominated this industry.
You might say PTs are the experts when it comes to shoulder injuries. While most physical therapists treat shoulders, OTs are typically more experienced when it comes to the upper extremities.
According to the American Association of Occupational Therapy, “Occupational therapy is the only profession that helps people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities (occupations).
Occupational therapy practitioners enable people of all ages to live life to its fullest by helping them promote health, and prevent—or live better with—injury, illness, or disability.”
More and more OTs are ignored in the medical community and unable to achieve their full potential due to cultural barriers and medical staff who don’t understand what OTs do.
What OTs can do to reclaim their profession from PT
What’s the solution? I’m not sure I know the solution. Education is one way to inform others about what OTs do, but most people working in the medical field won’t change unless it comes from the top down.
I do think directors of rehab have a role to help OTs reach their potential. This means allowing OTs to more fully evaluate and assess patients as a whole even if it overlaps with other professions.
Another way for OTs to develop careers in PT dominated fields is by venturing into those professions.
For example, an OT might look into becoming an athletic trainer or work at an outpatient PT clinic. OTs already work on the hand, wrist, digits, and shoulder. Some OTs even work on the pelvic floor. Why not the lower extremities?
Many OTs are afraid to assess the lower extremities, because that’s for PTs to assess only. It’s not! OTs need to be assessing the whole body and help patients work toward goals to help them become more independent in their daily occupations.
This is the reason I think OT is so much more important than PT. OTs don’t just look at biomechanics. They look at the whole picture to help people achieve their goals.
David is the lead editor of OT Focus. He has been practicing as an Occupational Therapist since 2013. He specializes in acute care, hand therapy, and ergonomics.