The Difference Between Physical Therapy and Occupational Therapy and Why You May Need Both: Insights from a Dual-Licensed Clinician

By Benjamin Anayati, PT, DPT, MS, OTR/L

When people ask me what I do for a living, and I tell them that I am a physical therapist and an occupational therapist, they often respond with several questions. “What is the difference?” “Why do you need both degrees?” “Aren’t those the same jobs?” It never occurred to me how few people knew what makes these professions unique, and just how valuable they might each be for patients in need. The average individual seems to have an understanding of what physical therapy is generally, but does not know exactly what physical therapists do. Additionally, most individuals have never heard of occupational therapy, and its ability to improve individuals’ functional independence, assist individuals in their activities of daily living and enhance individuals’ overall quality of life. This article seeks to provide a better understanding of the similarities and differences between physical therapy and occupational therapy, the inherent value in both professions, and why patients may benefit from both.

TAKING A STEP BACK: HOW I BECAME A “DUAL”

In the fields of physical therapy and occupational therapy, it is rare to find a clinician licensed in both disciplines. This is likely because the average occupational therapy degree in graduate school takes about two and a half years to achieve, and; the average physical therapy degree in graduate school takes about three years to achieve. After four years working to earn an undergraduate degree, the time and expense of five and a half years of additional schooling can be daunting.

But after being exposed to both practice areas in high school and college, I knew I couldn’t choose just one. Fortunately, at the time, there was one school in the country that offered a “dual” program: The University of St. Augustine for Health Sciences in St. Augustine, Florida. (Unfortunately, the “dual” program is no longer offered by the University of St. Augustine for Health Sciences anymore.) Under the “dual” program, a student could earn both a master’s degree in occupational therapy and a doctorate degree in physical therapy in approximately three and a half years combined.

Three and a half years of graduate school versus five years of graduate school for two degrees: how was that possible? I knew it would be hard work, but there was no question — St. Augustine was the school for me. So in the Fall of 2014, I made my way from New York to Florida. About three and a half years later, I returned to New York as a double-licensed professional, and have been utilizing both degrees ever since.

WHAT ARE PHYSICAL THERAPY AND OCCUPATIONAL THERAPY AND HOW ARE THEY SIMILAR?

When asked what physical therapy and occupational therapy are, I often flip it back to the questioner: “what do you think?” The most common response I receive is, “well, doesn’t physical therapy help you after an injury and occupational therapy help you get a job?”

WRONG!

Well, partly wrong. While physical therapy may help you after an injury, and occupational therapy may help you get back to work, both disciplines are far more complicated than that.

Physical therapy is defined as “the treatment of disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise rather than by drugs or surgery; physiotherapy.” Occupational therapy is defined as “a form of therapy for those recuperating from physical or mental illness that encourages rehabilitation through the performance of activities required in daily life.”

At first glance, these definitions may look starkly different. The basic principle, however, is the same. Both physical therapy and occupational therapy are focused on getting patients back to “normal” after suffering from disease, injury, deformity, or illness. Whether it’s an athlete in physical therapy working towards running ten miles again, or a patient who suffered a stroke in occupational therapy working towards walking fifty feet again, both fields strive toward improving an individual’s level of function. Both practices are also most often offered in similar settings, such as inpatient rehabilitation, outpatient rehabilitation, schools, skilled nursing facilities, and home health.

SO HOW DO I KNOW IF I NEED PHYSICAL THERAPY AND/OR OCCUPATIONAL THERAPY?

Most frequently, physical therapy serves to benefit patients suffering from disease, injury, or deformity impacting the upper extremities (Notably, however, certain physical therapists and occupational therapists are certified in hand therapy and are trained in hand and arm-related diseases, injuries, deformities, and illnesses. A patient should always consult their physician before deciding what treatment is best for them.), lower extremities, and spine (for example, an individual who breaks their leg). Physical therapists are uniquely trained to improve movement, lessen discomfort, reestablish use, and thwart dysfunction. They do so through prescribing and monitoring exercises, performing manual therapy, and promoting patients to live healthier and more active lives.

Occupational therapy often serves to benefit patients suffering from illness impacting their ability to complete activities of daily living (for example, an individual who had a stroke resulting in the loss of function in the arm and hand). Examples of activities of daily living include eating, bathing, dressing, and grooming. Occupational therapists are uniquely trained to help patients achieve their specific goals, large or small. They do so through comprehensive evaluations, during which they consider how patients can adapt to their environments and how their environments can be adapted to them.

SO WHY WOULD I NEED BOTH?

Despite their differences, physical therapy and occupational therapy focus on independence through functional wellness. Often times, disease, injury, deformity, and illness impact both patients’ physical capacities and abilities to achieve their daily objectives. Using the examples above, while a patient with a broken-leg most certainly would benefit from physical therapy, the patient may also benefit from occupational therapy to assist in bathing, dressing, and grooming while still in a cast. Similarly, while a patient who recently suffered a stroke resulting in the loss of function in the arm and hand most certainly would benefit from occupational therapy, the patient may also benefit from physical therapy in gait training, further strengthening and stretching muscles/joints, and engaging in balance training. In fact, more often than not, patients will benefit from both practices, neither of which should be underestimated.

Concluding Thoughts

My decision to pursue degrees in both physical therapy and occupational therapy was largely motivated by my passion to take a holistic approach to patient wellness. At times, I was unsure about whether I could achieve this goal, given the medical field’s view of physical therapy and occupational therapy as two, distinct practice areas. Fortunately, I have been pleasantly surprised. At the outset of my career, I was engaged, in part, for my ability to treat patients from both perspectives. It has been a privilege to see my patients benefit and grow from both physical therapy and occupational therapy. I look forward to continuing to treat and educate my patients with a comprehensive approach and encourage physicians, schools, and therapists around the world to consider the benefits that both disciplines provide in their unique ways.