Occupational Therapy vs Physical Therapy

'What Is The Difference, Which Is More Effective?'

By Definition –

Occupational therapy and physical therapy differ in their functional uses. Physical therapy is primarily concerned with building up muscles/ strength to treat an injury, while occupational therapy focuses on helping you to maintain independence or achieving an activity by being able to open cupboard doors, turn handles or walk upstairs.

The Short Answer –

Occupational therapy vs physical therapy is a choice that you may have to make as a patient. But which do you pick? Is physical therapy more effective? Is occupational therapy more useful? The answer depends on many factors, but if your doctor hasn’t already referred you, this is a vital decision you may need to make.

What Is The Difference Between a Physical Therapist And An Occupational Therapist?

On the face of it, this should be an easy question to answer, but with so many similarities, the differences are often blurred amongst well-meaning waffle around achieving ‘long-term positive outcomes for patients’ (as if any treatment doesn’t aim to do that), the actual difference can be lost.

To give you an example of what I mean, the American Physical Therapy Association defines the activity of physio’s as

“physical therapists can teach patients how to prevent or manage their condition so that they will achieve long-term benefits”

Meanwhile, the American Occupational Therapy Association tries to define their practice of occupational therapy through similar terms..

“In its simplest terms, occupational therapists and occupational therapy assistants help people across their lifespan to participate in the things they want and need to do through the therapeutic use of everyday activities” 

Hardly precise and to the point for a normal person to understand the differences. This is perhaps not surprising either given that both professions will often work side by side as part of a rehabilitation team.

Furthermore, it is not unusual to find traditional training merged in practice to include a bit of both therapies delivered for the patients benefit. Such an approach however, while undoubtedly well meaning, are more likely to provide a smudged, less effective overall treatment.

six examples of jobs done by an occupational therapist

I find the easiest way to explain the difference is as follows –

Physiotherapy seeks to treat physical problems that restrict normal movement by retraining their muscles and increasing their bodies strength/ mobility through a combination of exercise, manual therapy and education to overcome the specific effects of a disease, accident or operation.

Occupational Therapists focus on helping people complete daily tasks such as opening cupboards, getting dressed, climbing stairs or carrying the shopping.

They take a more holistic view that can include understanding the psychology behind your desires and advising on environmental changes or extra supportive equipment to make an outcome possible.

Patient Example…
If you have a knee replacement you are very likely to need extensive physical therapy (physio) to regain the movement/ strength in your knee to walk again. You may then decide to visit an occupational therapist if you still are having trouble walking downstairs with your new knees or if your passion was cycling and you are desperate to get back on the back, but cant with the less prosthetic.
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Occupational Therapy vs Physical Therapy – How They Are Similar?

However, while occupational therapists and physio’s may both have a very different core focus, it is also true that they do share certain similarities.

  • They both treat people through education around how to prevent further injuries and the healing process in general.
  • They both try to help people perform their daily activities through personally-tailored rehabilitation
  • They both insist on meeting you first for an initial assessment, during which they formulate a plan for rehabilitating you, before starting ‘intervention’ (treatment) on the next appointment.
  • Throughout the process they will continue to check your progress against their desired outcomes to try and find solutions for you

However, The Question Still Remains – Should You See A Physical Therapist OR An Occupational Therapist?

The answer depends of what you are seeking to achieve.

If you’ve just been diagnosed with rheumatoid arthritis or have a child with physical disabilities, then it is likely an occupational therapist will be your main port of call.

However, for any injury the physio would most likely be your first contact. This would then be followed by the occupational therapist getting involved after you’ve discharged from the hospital to ensure a smooth transition in to your home.

Typical Reasons To See A Physical Therapist (Physio)
a) An injury as a result of an accident
b) For rehabilitation following major surgery such as a knee/ hip replacement
c) To help recovery immediately following a sporting challenge such as a football match or marathon.

Typical Reasons To See An Occupational Therapist
a) Following recovery from surgery you find yourself to be struggling with some simple skills around the house or when trying to get back to work, through the re-engineering of certain key skills
b) Helping children with physical or even learning disabilities to participate fully in school
c) Providing support for adults with conditions such as arthritis, where cognitive activities such as opening cupboard doors, climbing stairs etc, may become difficult.

Occupational Therapy vs Physical Therapy – Which Is More Effective?

I include this question because I have been asked it several times. The simple (and most obvious) answer is neither. However, because sitting on the fence helps no-one, I will answer by saying it depends what you are looking to achieve.

If you have a very specific goal or are starting the fight against a chronic disease that is likely to affect your ability to function as normal, then an occupational therapist is your best option.

Occupational therapists take the most ‘holistic’ view of your circumstances and are much more likely to examine your entire environment, understand the full task ahead, analyse why you need help and if there easy fixes available and measure their success precisely against the achievement of your goals.

Physical Rehabilitation vs Achieving Your Goals

Physios however can also be very successful in their own right – but do so by focusing specifically on an injury and working intensely with the movement of your body to achieve fast, fluid movement and rehabilitation of that particular body part.

The knee replacement example above is actually quite a good one, because in that example, the physio would be the best person to ensure your body accepted the new prosthetic kneecap and that you were soon able to stand and walk on your knee.

However, a prosthetic knee is still a very different and less flexible body part than the cartilage/bone that it replaced in your original knee and this will make certain actions, like walking downstairs or cycling much more difficult.

This is then when an occupational therapist might step in, taking a much more rounded view to help you redesign the way you walk (and your expectations), so that you take stairs slowly and at a different angle to make the process much easier.

The National Board For Certification Of Occupational Therapy sum this up neatly arguing that what makes an occupational therapist is this uniquely holistic approach that can include ‘wellness, rehabilitation and habilitation’.

Which is most effective then depends entirely on what your needs are in the first place. 

Conclusion.

Hopefully by now you could answer the question ‘what is the difference between a physical therapist and an occupational therapist’ and know which profession you might refer to in any given circumstance.

Both could perform a vital role in your rehabilitation from an injury. But even then, they too are only small cogs within a full recovery process that may take months and require numerous dedicated activities, treatments and supportive aids, depending on your individual condition.

Hopefully, you will never be in a position to have to compare occupational therapy vs physical therapy, but if you are – don’t be afraid to ask to use them both.

They compliment each other far more than they compete and frequently work together in providing the best ‘holistic’ rehabilitation possible.

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References –

1. The American Physical Therapy Association. http://www.apta.org/AbputPTs/
2. The American Occupational Therapy Association. http://www.aota.org/about-occupational-therapy.aspx
3. The National Board For Certification Of Occupational Therapy. https://www.nbcot.org/

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