Physical therapists do diagnose patients, but the type of diagnosis they provide is distinct from that of a physician. As movement science experts, physical therapists evaluate and diagnose functional impairments—problems related to a person’s ability to move and perform daily activities. This diagnostic process is a core component of their professional autonomy and guides the development of a tailored treatment plan. The physical therapist’s diagnosis focuses on the consequences of an injury or disease, rather than the underlying pathology itself.
The Physical Therapy Diagnostic Label
A fundamental difference exists between a medical diagnosis and a physical therapy diagnosis. A medical diagnosis identifies the underlying disease, pathology, or structural injury, such as an Achilles tendon rupture, multiple sclerosis, or osteoarthritis. These diagnoses focus on specific anatomical tissues or systemic conditions causing the symptoms.
In contrast, the physical therapy diagnostic label classifies the resulting limitations in movement, activity, and participation. For example, a person with a medical diagnosis of a torn ligament might receive a physical therapy diagnosis of “Impaired Gait” or “Shoulder Mobility Deficit.” This functional diagnosis describes how the pathology affects the patient’s ability to live and move.
Physical therapists focus on identifying and classifying movement system dysfunction to determine a prognosis and guide care. They use standardized terminology, often framed by the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) model. This framework provides a common language for describing body functions, activity limitations, and participation restrictions, which are the core elements of the physical therapy diagnosis. The diagnosis directs the plan of care toward restoring movement and participation.
The Functional Movement Assessment
Physical therapists arrive at their diagnostic label through a comprehensive functional movement assessment designed to analyze movement patterns. The evaluation begins with a thorough patient history, where the therapist gathers information about symptoms, functional goals, and the impact of the condition on daily life. This initial step helps to contextualize the patient’s complaints within their overall function and activities.
The physical examination involves a systematic review of body systems, followed by specific tests and measures. Therapists observe posture and gait, noting any compensations or deviations from normal movement patterns. They perform objective tests to measure range of motion, muscle strength, and flexibility, often comparing the affected side to the unaffected side.
Specialized functional tests are then used to assess overall movement quality, balance, and coordination. These may include observing a deep squat, a hurdle step, or the ability to perform a single-leg stance, which require a complex interplay of mobility and stability. The diagnosis is derived from synthesizing all this data—the history, objective measures, and movement observation—to pinpoint the source of the functional limitation. This movement-based analysis differentiates the physical therapy assessment from medical diagnostic tools like imaging or laboratory work.
Navigating Direct Access and Medical Referral
The ability of a physical therapist to diagnose is closely tied to direct access, which is the public’s right to seek physical therapy services without a physician’s referral in most states. Direct access allows patients to receive immediate evaluation and diagnosis for musculoskeletal conditions, often reducing delays in starting treatment. This streamlining of care recognizes physical therapists as independent healthcare professionals.
This autonomy requires the mandatory screening for serious medical conditions, known as “red flags.” Red flags are signs or symptoms suggesting a condition is outside the scope of physical therapy practice, such as a systemic disease, fracture, or tumor. If a physical therapist identifies these signs during the initial evaluation, they are obligated to immediately refer the patient to a physician or other appropriate healthcare provider for a medical diagnosis.
Physical therapists act as primary musculoskeletal screeners, ensuring patients are appropriate for physical therapy intervention. The therapist must also refer a patient if the condition is not improving after a set period, depending on state regulations. This referral process confirms that while physical therapists diagnose movement dysfunction, they do not replace the role of a physician in diagnosing systemic illness or pathology.