Abstract
According
to the United States Citizenship and Immigration services Physical therapy is
one of the profession in Group 1 Schedule A occupations and the only other
occupation listed in this is registered nurse (USCIS). There is a widespread
demand and need for physical therapists in the United States. This demand can
vary based on the geographic area, with urban areas having more demand in comparison
to rural areas which have overall less healthcare facilitates. According to the
US Bureau of Labor Statistics (BLS), the growth of physical therapy as a
profession is predicted to be at 17% higher than average of any other
profession between the years 2021 to 2031. Even though there is high demand,
high paying jobs available there are a high number of professionals leaving the
profession or opting for non-clinical options due to burn outs. Optimizing
hands-on techniques and incorporating instrument-assisted manual therapy can
reduce physical strain, improve patient care, and enhance therapist job
satisfaction. This article explores the current state of physical therapy, the
symptoms of burnout, and effective strategies to optimize hands-on techniques
to reduce burnout.
1.
Introduction
Physical
therapy is usually the first line of action for most musculoskeletal issues,
recognized by the U.S. Citizenship and Immigration Services as a Group 1
Schedule A occupation due to its high demand (USCIS). The U.S. Bureau of Labor
Statistics predicts a 17% growth in the profession from 2021 to 2031, with an
average of 15,600 job openings annually, primarily to replace therapists
leaving the field (BLS). Despite the demand, physical therapists face
significant challenges, including high patient loads, administrative burdens,
and physical demands, which contribute to burnout. This article examines the
impact of these challenges and explores strategies to optimize hands-on
techniques, aiming to improve patient care and reduce therapist burnout.
2.
Reducing Labor Force
Clinical
physical therapists often experience high patient loads, long working hours,
and insufficient rest, exacerbated by administrative tasks such as extensive
paperwork and managing multiple patients simultaneously (Smith & Doe,
2022). The emotional toll of treating patients with chronic pain and illness
further contributes to therapist burnout. Additionally, productivity demands
driven by reduced insurance reimbursement result in inadequate management
support and staffing, leading to poor work-life balance. Physical demands,
including standing all day, assisting with patient transfers, and performing
manual therapy, also play a significant role in therapist burnout (Jones &
Taylor, 2021).
3.
Manual Therapy Skills
Physical
therapists and assistants invest substantial effort in manual therapy skills,
including myofascial release, trigger point release, massage techniques, and
mobilization. These techniques, performed daily, place considerable physical
strain on therapists' hands, wrists, elbows, backs, necks, and legs, leading to
chronic joint and muscle injuries (Brown & Green, 2020). Therapists often
work through pain to meet patient expectations, but this can only be sustained
for a limited period before symptoms of fatigue set in.
4.
Symptoms of Burnout
Physical
fatigue is the most common symptom of burnout, manifesting as chronic aches and
pains in various joints and muscles (White & Black, 2019). Emotional stress
from constant interaction with patients in pain and chronic illness further
exacerbates burnout. Decreasing reimbursement rates have increased billing and
productivity expectations, forcing therapists to manage multiple patients
simultaneously, reducing direct one-on-one patient care, leading to poor
patient experiences and job satisfaction (Davis & Lee, 2018).
5.
Using Manual Therapy Equipment to Prevent Physical Burnout
Performing
manual therapy for eight to ten hours daily and meeting patient expectations
can be daunting. Instrument-assisted manual techniques or other low-force
methods can effectively address this challenge. Common body parts targeted by
therapists include the cervical area, upper back, shoulders, lower back, hips,
IT band, and calf area (Martin & Clark, 2023). Embracing the use of these
tools can transition therapists from hands-on practice to optimized patient
care, reducing physical strain.
6.
Effective Techniques and Tools
1.Foam Rollers: Substituting foam
rollers for myofascial release to address IT band and hip tightness can be
highly effective. Educating patients to use foam rollers as part of their home
exercise program can enhance results. This can reduce the recovery time and
improve patient satisfaction (Johnson & Smith, 2021).
2.Graston or Similar Tools: Use of Graston or similar tools can be highly effective for almost all muscle groups. These techniques have been shown to reduce physical stress and are effective in breaking down scar tissue post-surgery and reducing fascia tightness. They can result in faster recovery, reducing overall healthcare costs associated with that incident, improving patient satisfaction, and enhancing therapist morale and job satisfaction (Thompson & Rogers, 2020).
3.Trigger Point Dry Needling (TDN): Use of trigger point dry needling has been proven to be extremely effective in-patient care. Trigger point dry needling (TDN) involves using thin stainless-steel needles introduced in tissue with pain or nociceptive areas to obtain a twitch response or a muscle contraction, achieving an optimal muscle length-tension relationship within the muscle and improving blood flow post-exercise. This technique has specific guidelines based on the practice act in which the therapist practices, and the therapist might also need extensive training and supervised hours of practice (Nguyen & Patel, 2019).
4.Cupping Therapy: Use of cupping therapy in conjunction with manual therapy has been shown to reduce pain and swelling much faster compared to only manual therapy. Cupping helps increase local blood flow to warm the tissue, which can then be followed by manual therapy as needed. This does not replace manual therapy but reduces the strain on the therapist, leading to optimal results with less physical effort. Therapists need to ensure that the patient is comfortable with cupping, skin integrity is not compromised, and proper hygiene is maintained to reduce infection risk (Cooper & Wells, 2018).
5.Thumb Saver Tools: The use of thumb saver tools is a more ergonomic way to provide trigger point release or manual therapy as required. Thumb savers can be used for manual therapy on those deep tissue tightness, knots, or trigger points requiring a lot of force on the thumbs. This helps reduce strain on the thumb and hands (Adams & Carter, 2017).
7.
Conclusion
The
physical therapy profession is undoubtedly in high demand all over the United
States, especially with the baby boomer population entering their geriatric age
group. The education requirement is high for someone to become a physical
therapist, and then to practice, the individual needs to clear the national
physical therapist examination. After all the hard work, many therapists end up
changing professions due to burnout. Using manual therapy strategies to reduce
physical strain is important to improve patient satisfaction, reduce treatment
time, and embrace job satisfaction. Further studies should be performed to dive
deep into how to reduce therapists’ mental strain, optimal productivity
requirements per therapist, and optimal reimbursement rates.
8.
References