Body Language in Physical Therapy

In the world of medical professions, communication is key in a patient-provider relationship. In Physical Therapy, like all other medical professions, this fact rings true. As a physical therapist, your job is to evaluate and treat pains or mobility issues your patient is having, and in doing that you need the patient to trust you, be comfortable talking to you, and be in close proximity to you. While the majority of communication is verbal such as, “How does that exercise feel?” or “There is pain over my right kneecap,” it is not the only way communication happens. I have found that nonverbal communication, such as reading body language, is also essential in a patient-therapist relationship and can be just as important as the verbal conversation between the two. 

Body language is a type of nonverbal communication, made up of gestures and movements. Things like posture, tone of voice, nervous ticks, or eye contact are all considered types of body language. Being able to read body language is important in all types of relationships; for example, most of my team knows that when I am nervous for a race I avoid eye contact and get very fidgety or my coaches know that when my knee hurts I start pushing off the wall with one leg. Both examples seem to send obvious messages, but it doesn’t matter if they are obvious, people need to be able to read them and empathize. By reading someone’s body language you are able to understand their emotions on a deeper level. A physical therapist – patient relationship is no exception, it is important for both of them to be able to read each other throughout their sessions together. 

As I will say numerous times, a patient needs to be able to trust the physical therapist within the first couple minutes of the first appointment because from that time on you will be handling the patient’s pain. This could include teaching exercises, measuring range of motion, and manual therapy. A physical therapist’s body language needs to be open. My very first physical therapist and long time friend/mentor, Nikki Clifford explains that, “In my profession people come to me for help, they come to me in pain, they come to me scared of the unknown…I get about 15 minutes [upon meeting them] to inquire, learn, and formulate a plan to help… and in that 15 minutes I need to be able to establish rapport that will allow for the trust needed to do things.” It is important when talking to a patient that a physical therapist shows very open body language, such as uncrossed arms and legs, actively listens, and never cuts them off or seems to be rushing. It is important that a patient trusts and feels comfortable with their physical therapist so that they can reap all the benefits of the treatment plan created specifically for them.

While you would think because people go to physical therapy to stop their pain, the patient would always be outright with how they are feeling. Unfortunately, that is not true and I can tell you that from personal experience. When I discussed this topic with a physical therapist I have shadowed on multiple occasions, Lauren Rossi said, “we can also read patient body language to know their pain levels or to see if they are being honest and open with us.” Sometimes as a patient, you attempt to power through pain you are having because you are trying to get cleared to get back to a certain activity (I was that patient all the time) or because you are frustrated with a pain that has been there for so long and you just want to be done, so you pretend you are fine. When I was in physical therapy, I would tell my therapist all the time that something didn’t hurt that much and somehow they always knew when I was lying. It’s not because they all had superpowers that let them read my mind (though that would’ve been cool), they were just paying attention to me. No matter which therapist I was with at that point (and I have had about 8) they all knew when I was lying because they really focused in on certain gestures I was making; for instance if something hurt I would bite my lip or clench up. Physical therapists also can look at how the patient is performing the exercise to see if they are in pain. They specifically look for whether or not the patient is favoring one side over the other, or how much pressure they might be putting on one side. For instance, if a patient is doing squats, they can watch and see if they are leaning more on the left leg rather than evenly distributing their weight. Pain is not the only emotion physical therapists look for in their patients’  body language. 

Injuries and surgeries can burden a person mentally and physical therapists know this, and good ones don’t ignore that fact. Rossi once told me, “often patients don’t feel as though doctors take the time to really listen to them… we as physical therapists often become “therapists” too!” As a physical therapist asks patients questions about their pain, they ask many follow up questions to find the tiny details of actions that could be causing more pain. These conversations cause the physical therapist to learn a lot about the patient’s life, and the more personal the relationship becomes the easier it is for the patient to trust their physical therapist. When I was in high school I consistently went to the same physical therapist, and he was one of my favorites out of all the ones I ever went to because he knew how to read my body language and looked out for my mental health just as much as my physical health. He knew when I came in if I was having a bad day, and he would always try to help. I have had issues with my knees for years and it has always affected my swimming but at this point in high school it was really bad and a lot of people were telling me to quit. My physical therapist encouraged me to keep at my exercises and swim as much as I could because eventually I would get my pain under control. My physical therapist kept me from making the terrible mistake of quitting and not swimming in college, which ended up becoming one of my favorite parts of college. Even if a physical therapist notices small things like that their patient has bad posture or is looking down a lot, they can see that there might be something that is bothering the patient. Reading and knowing when a patient is going through a difficult time because of their injuries or if they are just having a bad day can make their sessions more personable and make a stronger connection between patient and physical therapist.

There is definitely more to reading a patient’s body language than there is to the body language of the physical therapist, but they are equally important to creating a good patient-physical therapist relationship. There are so many aspects of the relationship between patient and physical therapist, however knowing about body language can enhance the patients’ experiences. The better the relationship, the more likely the patient will be successful in reaching their goals.  

She is currently practicing physical therapy at Cape May County Special Services School in New Jersey and at Weisman Children’s Outpatient Rehabilitation Center in Northfield, New Jersey.

She has previously practiced physical therapy at multiple outpatient locations. She is the previous Director of Kean University’s Doctoral of Physical Therapy program. She now serves as the Associate Dean of the School of Health Professions and Nursing at LIU-Post.

Works Cited 

Belber, Nicole, and Lauren Rossi. “Lauren Rossi, DPT .” 22 Mar. 2020.

Belber, Nicole, and Nikki Clifford . “Nikki Clifford, DPT.” 2 Apr. 2020.

“Body Language.” Psychology Today, Sussex Publishers, www.psychologytoday.com/us/basics/body-language.

“Nonverbal Communication.” HelpGuide.org, 16 Apr. 2020, www.helpguide.org/articles/relationships-communication/nonverbal-communication.htm.

“Nonverbal Empathy.” Improve Your Social Skills, www.improveyoursocialskills.com/empathy/nonverbal-empathy.