AARP Smart Guide to Physical Therapy

Understand what to expect and how it can help you heal, move better and manage chronic conditions

Michelle Crouch,

AARP

Reviewed by

Peter Ronai

Comments

Published April 17, 2026

Still life of a purple foam roller, teal water bottle, and resistance band.

Want to stay active and independent as you age? Read on to learn how physical therapy can help.

AARP (Shutterstock)

Key takeaways:

What to know before you start and choosing a physical therapist: Physical therapy helps older adults move better and stay independent. Results improve when you choose a licensed therapist who treats your specific condition.
Paying for physical therapy and reasons to see a physical therapist: Therapy can ease pain, improve balance, manage chronic conditions and support recovery. Coverage depends on insurance rules, referrals and Medicare guidelines.
What to expect, tools and equipment, assistive devices and getting results: First visits include an evaluation and a plan. Treatment may consist of hands-on care or equipment. Progress depends on doing home exercises and speaking up about your needs.

When you think of physical therapy, you may picture an athlete getting help while recovering from an injury, or a patient rehabbing after a joint replacement. But for older adults, physical therapy can play many other important roles.

If aching knees or hips are slowing you down, physical therapy can ease pain, reduce the need for medication and help you delay, or even avoid, surgery. Physical therapy can also make you stronger and steadier on your feet, help you manage chronic conditions, restore function after a stroke and treat problems such as dizziness or incontinence. In short, physical therapy can help older adults stay active, safe and independent longer.

We spoke with experts in the field about different types of physical therapy, the conditions it can help with, what to expect at your appointment and how to get the most out of treatment.

Physical therapist helping a senior man with resistance band exercises during a rehabilitation session

One of the primary goals of physical therapy is to ensure that you remain active and move safely.

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WHAT TO KNOW BEFORE YOU START

1. What is physical therapy?

Physical therapy is a health care treatment that helps people move better and function more comfortably in everyday life. Physical therapists evaluate how your body moves and then tailor a treatment plan to your specific needs. They may guide you through strength or stretching exercises, work on balance and coordination, or use hands-on techniques to loosen stiff joints and muscles. Physical therapists typically get an undergraduate degree and then complete a three-year program to earn their Doctor of Physical Therapy degree.

2. How physical therapy differs from other types of care

Physical therapy is sometimes confused with other types of care that involve movement and hands-on techniques, but there are important differences. For example, occupational therapists help people perform everyday tasks such as dressing and eating, while chiropractors target spinal alignment and joint adjustments to relieve pain and improve function. Athletic trainers specialize in preventing and treating sports-related injuries. Personal trainers, by contrast, work on general fitness and conditioning.

3. Why physical therapy is important as we age

Physical therapists teach patients how to move safely and stay active. Those skills don’t just help older adults continue doing the activities they enjoy; they’re also important for preventing falls and boosting overall health. “As we age, we start losing muscle mass and bone density, and our balance gets worse,” says Robyn Culbertson, a board-certified specialist in geriatric physical therapy in Columbia, South Carolina, and a spokeswoman for the American Physical Therapy Association (APTA). “We can help make adaptations to the way you interact with your environment to keep you safe, strong and healthy.”

3. Types of physical therapists

All physical therapists are trained to evaluate, diagnose and treat a variety of symptoms and conditions. Some are board-certified specialists, meaning they received advanced training in one of 10 specialty areas: cardiovascular and pulmonary, clinical electrophysiology, geriatrics, neurology, oncology, orthopedics, pediatrics, sports, women’s health or wound management. But even without board certification, many physical therapists focus on a particular condition, such as lower back pain or pelvic floor problems. Therapists practice in hospitals, nursing homes and outpatient clinics. Some offer telehealth and home visits.

Physical therapist talking with a patient during a consultation in a brightly lit clinic

Doctors' recommendations and online reviews can help you find a good physical therapist.

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CHOOSING A PHYSICAL THERAPIST

4. Ask who your doctor recommends

Your doctor can recommend a physical therapist, especially if you’re looking for someone who treats a specific condition. But keep in mind that some physicians own physical therapy practices or refer patients only to clinics within their own health system, creating a potential conflict of interest, according to Joe Hribick, a clinical assistant professor of physical therapy at Lebanon Valley College in Pennsylvania. “Some physicians say, ‘We will schedule you downstairs for Monday,’ and patients think that’s what they have to do,” he says. “But you have every right to choose what physical therapy practice you want to go to.”

5. Read reviews and get recommendations

Check sites such as Google Reviews to learn about other patients’ experiences with a clinic, including how attentive therapists were and whether appointments felt rushed. Zocdoc and Consumers’ Checkbook also have reviews of physical therapists. And don’t forget about family and friends, who can give you the names of physical therapists who have helped them.

6. Verify credentials

To ensure high-quality care, make sure the therapist is licensed in your state. Look for the credentials “PT” or “DPT,” meaning they hold a doctorate in physical therapy. Licensed providers must pass the National Physical Therapy Exam, which is administered by the Federation of State Boards of Physical Therapy. They must also meet state requirements before they can practice. You can use the APTA’s “Find a PT” tool to search for licensed therapists in your area who meet your specific needs.

7. Consider a therapist who specializes in your condition

Many therapists focus on certain conditions or body areas, Hribick says. If possible, he recommends choosing a therapist who regularly treats patients with issues like yours. You can often find that information on their websites or by calling the clinic and asking. Therapists who specialize will have deeper knowledge and advanced training, Hribick explains, and are more likely to follow the latest research. “There are so many nuances for a lot of these diagnoses that it’s better to find someone who has a little more training or specialty in that area,” he says.

8. Ask how sessions are structured

At some clinics, patients work one-on-one with the same physical therapist at each visit, while others may have therapists treating two or more patients at a time. Many practices also use assistants who work under a therapist’s supervision.

Culbertson suggests asking a few questions about how care is delivered: How long are sessions? Will the therapist be working with more than one patient at a time? And how often will you see the physical therapist versus a physical therapy assistant? It can also help to ask how many patients the therapist typically sees in an hour, says Rachel Prusynski, a neurologic physical therapy specialist and APTA spokeswoman. Therapists who see 18 or 20 patients in a day may find it difficult to provide individualized care, especially for people with more complex conditions.

Close-up of a Medicare insurance card and a stethoscope on top of medical paperwork

Medicare covers physical therapy, but your doctor must approve the treatment plan.

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PAYING FOR PHYSICAL THERAPY

9. Do you need a referral?

All states and the District of Columbia allow patients to go straight to a physical therapist without a referral. But some jurisdictions limit how long treatment can continue without a physician’s involvement. Your insurance plan may also have restrictions. Some plans require a referral before covering physical therapy, and many limit the number of visits they will pay for. Traditional Medicare does not require a referral before your first physical therapy evaluation. However, your health care provider must sign off on the treatment plan within 30 days and certify that the therapy is medically necessary.

10. In network or out of network: What’s the difference?

Going to an in-network provider usually means lower out-of-pocket costs, while seeing an out-of-network provider may require higher copays or full payment upfront. Most clinics can contact your insurance company and let you know what you would owe for each session and if there’s a limit on how many visits you’re allowed, says Culbertson.

11. How Medicare covers outpatient physical therapy

Medicare covers outpatient physical therapy as long as a doctor certifies that the treatment is medically necessary, and there’s no set limit on the number of visits. (There is an annual threshold that comes into play once a certain amount has been spent.) Coverage begins after you’ve met your annual Part B deductible. After that, you pay 20 percent of the approved cost for each visit.

12. How Medicare covers inpatient care

If you need more intensive rehabilitation after a stroke, major injury or surgery, Medicare Part A may pay for a stay at an inpatient rehabilitation facility. In most cases, you pay nothing for the first 60 days after meeting the Part A deductible. Medicare may also cover physical therapy at a skilled nursing facility following a hospital stay of at least three days. After the deductible is met, you usually pay nothing for the first 20 days of care. Medicare may cover in-home services if you’re eligible for home care.

An older woman sitting on the floor after a fall, appearing distressed

Falls are one of the biggest reasons that older adults end up going to physical therapy.

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BENEFITS OF PHYSICAL THERAPY

13. Boost balance training and fall prevention

If you’ve had a fall, seeing a physical therapist is a no-brainer. But you don’t have to wait until you take a tumble to get help. Hribick recommends that all adults over 65 consider getting a balance assessment to identify problems early and reduce the risk of falls, which are a leading cause of injury among adults in that age bracket. About 1 in 4 older adults reports falling every year. “We start to see balance changes with anyone over the age of 60,” he says.

A physical therapist can run some simple tests to assess your fall risk and create a prevention plan. A 2023 systematic review published in Frontiers in Public Health found that strength and balance training programs such as those used by physical therapists can significantly reduce falls among older adults.

14. Reduce joint and muscle pain

Many older adults live with pain that makes daily activities more difficult. Physical therapy can help by building strength, retraining movement patterns and addressing the underlying issues causing the pain. That could eliminate the need for medications or even surgery, according to Jeanne Ubalde, a physical therapist in Longview, Texas. “I see people who don’t want surgery,” Ubalde says, “and they get better.”

Research indicates that physical therapy could control pain even better than over-the-counter medications. A 2025 study published in the International Journal of Environmental Research and Public Health found that older adults with osteoarthritis who participated in two months of physical therapy reported less pain and stiffness and a better quality of life compared with those taking nonsteroidal anti-inflammatories.

15. Reduce risks related to osteoporosis

Osteoporosis and low bone density affect 56 percent of Americans age 50 and older. Physical therapy can help them build strength, improve balance and learn safer ways to move, all of which reduce the risk of falls and fractures. Physical therapists often prescribe weight-bearing and resistance exercises to strengthen muscles and support bone health. They also teach posture and body mechanics that protect the spine, plus balance training to help patients stay steady on their feet. A 2023 systematic review published in the journal Osteoporosis International found that balance training significantly improved balance and reduced fall risk in people with osteoporosis.

16. Recovery after joint replacement

Thousands of older adults undergo hip and knee replacements every year, and physical therapy is key to their recovery. Therapy focuses on restoring strength, improving their range of motion and helping them return to their regular activities. If you have an upcoming surgery, therapists often recommend starting therapy up to eight weeks beforehand, a strategy known as “prehab.” The therapist can help you get as strong as possible before surgery, fit you with a walker and give you some exercises to begin right after the procedure, Culbertson says.

17. Recovery after stroke

Physical therapy plays a key role in helping people recover from a stroke by rebuilding strength and retraining the brain and body to work together again, says Prusynski, who is also an assistant professor at the University of Washington. The first few weeks are especially important because the brain is rapidly healing and reorganizing itself, she says. If possible, she recommends working with a neurological physical therapist who specializes in brain injuries.

After you’re discharged from the hospital, try to get admitted to an inpatient rehabilitation facility, where you’ll get three hours of therapy a day, rather than a skilled nursing home with more limited services.

“There’s a lot of evidence that if you participate in meaningful, functional tasks at a high level, like high repetitions and high intensity and effort, your brain changes for the better, faster,” Prusynski says. She stresses that physical therapy can continue to help people make progress for years after their initial rehabilitation period.

18. Help with Parkinson’s disease and other neurological conditions

Neurological physical therapy also helps people with conditions such as Parkinson’s disease, multiple sclerosis and ALS maintain mobility and independence. Therapy focuses on improving walking, balance and strength, as well as how to adapt and stay active as the disease progresses, Prusynski says.

If you have a progressive disease like Parkinson’s, don’t wait until your mobility is significantly impacted to start physical therapy. “We have good evidence that working with a physical therapist early in Parkinson’s can help slow progression,” says Prusynski.

19. Incontinence and other pelvic floor disorders

Physical therapy can help treat urinary incontinence, which affects 1 in 3 older adults or more. A 2023 meta-analysis found that pelvic floor training significantly improved symptoms and quality of life in women with the condition. Pelvic floor therapy may include exercises, breathing techniques and strategies to prevent leakage when coughing or exercising, says Ubalde. Therapists also assess whether the muscles are weak or overly tight, which can affect treatment.

“People say ‘Just do Kegels,’ but it’s not for all,” Ubalde says. “If that patient already has tension on the pelvic floor and you ask them to Kegel, which is tightening the pelvic floor muscles, you are going to worsen the symptoms.” Pelvic floor therapy can also help treat fecal incontinence, painful sex, erectile dysfunction and pelvic pain.

20. Dizziness/vertigo

If you’ve ever felt the room spinning when you roll over in bed or look up quickly, the cause may be a common inner-ear problem called benign paroxysmal positional vertigo. It happens when tiny crystals inside the inner ear’s vestibular system become dislodged and move into one of the ear’s semicircular canals, explains Ubalde, who specializes in vestibular physical therapy.

Physical therapists can often treat the problem using specific head and body movements designed to move the crystals back into place. “A therapist who is vestibular-certified or knowledgeable can do what’s called a head maneuver or repositioning to get those crystals out of the canal,” Ubalde says. Vestibular therapy can also help people whose dizziness comes from other causes.

21. Cardiopulmonary rehab

Cardiopulmonary rehab helps improve heart and lung function, increase endurance, and strengthen muscles in people with conditions like COPD, asthma, or heart failure, or those recovering from surgery. Therapy typically involves supervised exercise, breathing techniques, and strategies to make daily activities easier, says Jennifer Sharp, a specialist in cardiovascular and pulmonary physical therapy and an APTA spokeswoman. During sessions, therapists use a variety of tools to test and monitor heart and lung function. “I am always, always monitoring people’s blood pressure and heart rate,” Sharp says. “It gives me so much info about how [their] body is handling exercise, and how much I can push them.”

healthcare provider and a patient having a friendly discussion during a medical appointment

Come to your PT sessions in loose clothing and shoes you'd wear to the gym.

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WHAT TO EXPECT AT YOUR FIRST APPOINTMENT

22. What to bring and wear

Wear loose, comfortable clothing that allows the therapist to access the body part being treated, along with supportive athletic shoes. You’ll also need to bring your insurance card, a list of current medications, imaging results if your doctor didn’t send them electronically and any assistive device you use, such as a brace, cane or walker. If you’ve been prescribed nitroglycerin tablets for a heart condition, bring those as well. And if you wear glasses or contact lenses, don’t forget those.

23. Evaluation and assessment

Your first physical therapy visit usually begins with a comprehensive evaluation. The therapist will review your health history, ask about your symptoms and discuss what you hope to achieve, Culbertson says. The therapist will then likely run a series of strength and mobility assessments. They may test your range of motion, balance, strength and ability to perform everyday movements. For example, some therapists use a sit-to-stand test that measures how fast a patient can rise from a chair five times without using their hands. The results help therapists compare your performance with typical benchmarks for your age, and identify areas for improvement.

24. Creating a personalized plan

After the evaluation, the therapist may provide hands-on treatment to help relieve pain and improve your mobility, Hribick says. Then they will develop a treatment plan tailored to your condition, goals and overall health. Your therapist will also talk to you about visit frequency, how long treatment may last and exercises for you to do at home.

pink percussive massage tool with several different attachment heads on a black background.

Weights and exercise equipment are among the tools you'll use in PT.

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PHYSICAL THERAPY TOOLS AND EQUIPMENT

25. Standard equipment you’re likely to encounter

Physical therapists use a wide range of equipment and techniques to help you get back into tip-top form. Here are some of the most common ones.

Strength equipment. Weights, resistance bands, balance balls and other exercise tools can help build strength, stabilize joints and improve mobility and function.
Cardiovascular equipment. Treadmills, recumbent bikes and step machines help improve endurance, heart health and walking ability.
Balance training tools. Therapists may use moving platforms, foam pads and other unstable surfaces to challenge balance and reduce fall risk.
Harness systems. In neurological rehabilitation, harness systems allow patients to practice walking safely while part of their body weight is supported.
Braces and mobility aids. Therapists may recommend braces, walkers, canes or other assistive devices to support weak joints and improve mobility.
Neuromuscular electrical stimulation (NMES). Small electrodes placed on the skin send electrical impulses that activate weak muscles, helping restore movement after injuries due to a stroke or nerve damage. “You are trying to turn the muscle on,” Prusynski explains.
Transcutaneous electrical nerve stimulation (TENS). TENS therapy uses mild electrical currents to help block pain signals and provide temporary pain relief.
Ultrasound or shockwave therapy. These technologies use sound waves to stimulate healing and improve blood flow in injured muscles, tendons and ligaments.
Instrument-assisted soft tissue therapy. Therapists use specialized tools to loosen tight tissue and improve circulation. (The treatment is also sometimes called “muscle scraping.”) “What we’re trying to do is create a localized inflammatory response on the muscle to get good blood flow and wash away the pain metabolites,” Ubalde explains.
Cupping therapy. Suction cups placed on the skin gently lift tissue to improve circulation and relieve muscle tightness.
Dry needling. Very thin needles are inserted into tight muscles at specific points to release tension and improve mobility.

26. High-tech tools and equipment

The following cutting-edge equipment is coming into wider use in the physical therapy industry.

Anti-gravity treadmill. A type of rehabilitation treadmill in a chamber that uses differential air pressure to support some of your body weight, reducing the impact on your joints.
Isokinetic dynamometer. These specialized units can test strength without movement (isometrically) or guide a joint through a controlled, constant-speed motion (isokinetically).
Class 4 laser therapy machine. A noninvasive, high-intensity treatment that beams near-infrared light directly into tissue to reduce pain and accelerate healing.
Hyperbaric oxygen therapy chamber. A pressurized chamber where you can breathe 100 percent oxygen, which helps with healing by stimulating new blood vessel growth and increasing oxygen delivery to damaged tissues.
3-D gait analysis. These systems have motion-capture technology that allows physical therapists to analyze your walking or running gait, identify injury risks and develop personalized training programs.

Close-up of an elderly person's hand holding a cane while walking outdoors

If you use a cane, make sure it's the proper height.

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HELP WITH ASSISTIVE DEVICES

27. Using a cane properly

If you feel unsteady when walking, a cane can provide extra support, but only if it’s the right type and used properly, according to Culbertson. There are several types, including single-point canes, quad canes with wider bases, and newer designs like “HurryCanes,” which feature pivoting, tripod-like bases. A physical therapist can help you choose one that fits your needs and show you how to use it correctly.

One common mistake is holding the cane in the wrong hand. For most people, the cane should be held in the hand opposite the weaker or more painful leg so that it supports your weight as you step. Proper height matters, too. The top of the cane should reach about the crease of your wrist when you’re standing upright with your arms relaxed at your sides, says Culbertson.

28. Using a walker properly

Walkers can provide more stability than a cane, but they, too, must be fitted. “A lot of people get assigned a walker at the emergency room or the hospital, and nobody has fitted it to them,” Culbertson says. “I see people walking around, and it’s all I can do not to stop them and tell them it’s not the right height.” A properly fitted walker will reduce stress on your back and shoulders. According to the Mayo Clinic, when you rest your hands on the grips of your walker, your elbows should have a slight bend of about 15 degrees.

The type of walker matters, too. Rollators — walkers with four wheels and a seat — are popular because they allow people to sit and rest, but they provide less support and stability. A physical therapist can help determine which assistive device you need and ensure it’s fitted correctly.

29. Fitting your wheelchair

If you need to use a wheelchair, a physical therapist can take measurements and work with your vendor to ensure the chair is fitted correctly. “Wheelchairs that are too narrow side-to-side can cause skin breakdown,” Culbertson explains. “If they’re too wide, your arms aren’t at a good angle for propulsion.” You also want to make sure the seat doesn’t press against the back of your knees when you sit, because that can interfere with your circulation.

A person tying their sneakers before starting an exercise session

Take your PT sessions seriously, and do your homework.

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HOW TO GET THE MOST OUT OF PHYSICAL THERAPY

30. Address your injury promptly

Many mobility problems develop gradually and worsen if left untreated. Even if your symptoms are mild, consider getting an evaluation to find out what’s wrong and prevent the problem from getting worse. “Physical therapy isn’t just for treating injuries. It can also help prevent them,” Hribick says. “If you’re having pain and it’s not going away, don’t wait. Get it checked out.”

31. Speak up if something doesn’t feel right

Some soreness after physical therapy is normal, especially if you’re working muscles that haven’t been used in a while. But if you experience sharp pain or something that doesn’t feel right, tell your therapist, Culbertson says. Speak up, too, if you don’t like a specific technique or assigned exercise. “Good physical therapists are open to feedback,” she says. “We have plenty of things in our toolbox.” Your therapist can adjust the exercises, modify the treatment or talk to your doctor about any concerning symptoms.

32. Challenge yourself

In neurological physical therapy, many patients don’t work hard enough. “If you’re in rehab working with a PT and you’re not sweating, you’re not maximizing your potential,” Prusynski says. “Your brain needs your heart to work hard.” Research supports this: A 2023 review found that vigorous-intensity training after a stroke led to significantly greater improvements in walking than lower-intensity therapy.

33. Don’t skimp on your homework

Physical therapists know that many patients don’t do their assigned home exercises between appointments. But those exercises are critical for speeding recovery and getting the best results. If you can’t fit them all in, ask your therapist which three are the most important, and try to do at least one per day. Or ask about ways to work the movements into your everyday routine. “If I’m seeing a CEO who’s always sitting on Zoom meetings, I know she won’t have time to go to an exercise room,” Ubalde says. “So I’ll tell her to use a standing desk and do her leg exercises during a Zoom meeting.”

34. Keep up with your exercises after therapy ends

Once you finish your physical therapy, it’s important to continue the exercises you’ve learned. One way to stay consistent is to schedule them like an appointment. “Write it on your calendar,” Culbertson suggests. Another strategy is habit stacking, or tying exercise to routines you already do every day. Do a few squats while brushing your teeth, or stand on one leg while waiting for your coffee to brew.

35. Stay active

“Movement is medicine,” Sharp says. “If you had a physician give you a pill to take at a certain time every day, you would probably do that. Think about exercise being that medicine for your entire body, and make it something that is a priority. [Of] the older adults I see, the ones that do best are the ones that keep moving.”

The key takeaways were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.

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Michelle Crouch is a contributing writer who has covered health and personal finance for some of the nation’s top consumer publications. Her work has appeared in Reader’s Digest, Real Simple, Prevention, The Washington Post and The New York Times.

Peter Ronai is a clinical exercise physiologist and clinical professor of exercise science at Sacred Heart University in Fairfield, Connecticut. He is the associate editor-in-chief of the American College of Sports Medicine’s Health & Fitness Journal and teaches and writes about exercise strategies exercise professionals can use to help clients improve their strength, physical fitness, function and health-related quality of life. He is a fellow of the American College of Sports Medicine and the Clinical Exercise Physiology Association.