The physical therapy profession is under pressure. Burnout, student debt, declining reimbursement and hiring challenges have created a strained environment for clinicians and employers alike.
As the need for musculoskeletal care continues to grow, a new study from Evidence In Motion faculty explores whether post-professional education could help improve one critical factor: how long physical therapists stay in their jobs.
The pilot study, co-authored by Adriaan Louw, PT, Ph.D.; Teresa Schuemann, DPT, SCS, ATC, CSCS; Kristin Smith, PT, DPT, D.Sc., OCS, FAAOMPT; Laurence Benz, DPT, OCS, MBA; and Kory Zimney, PT, DPT, Ph.D., CSMT, TPS, CAFS, ACCIP, examined whether there is a correlation between receiving post-professional certification or residency training and length of employment.
The results show a meaningful insight. One certification program, the therapeutic pain certification, was associated with significantly longer employment.
The Workforce Challenge
Musculoskeletal pain is one of the most common reasons people seek medical care. As rates of chronic pain increase, physical therapists are well positioned to deliver evidence-based, nonpharmacological care.
Yet the physical therapy workforce is shrinking in some areas. The COVID-19 pandemic led more than 22,000 therapists to leave the profession. Meanwhile, burnout, administrative burden and financial stress continue to affect retention.
Although the number of licensed physical therapists in the United States is growing, now estimated at 225,000 according to the American Physical Therapy Association, the outpatient setting continues to experience high vacancy rates and difficulty hiring.
The authors of the study wanted to better understand whether continuing education, particularly post-professional certifications and residencies, might affect how long therapists stay with their employer.
What the Data Shows
Researchers examined 121 outpatient orthopedic physical therapists working in a large clinical organization that also houses a post-professional education division. Ninety-six therapists had completed a certification or residency; 25 had not.
Four educational tracks were included in the analysis: pain certification, manual therapy certification, orthopedic residency and sports residency. Researchers reviewed employment data to evaluate how long therapists worked before and after their post-professional training.
The most significant result was that therapists who completed a pain certification had a longer mean employment duration than those without any post-professional training. Pain-certified therapists had worked an average of 8.25 years compared with 5.13 years for those with no certification or residency. This difference of just over three years was statistically significant.
Average employment duration in years by training type. Physical therapists who completed a pain certification had the longest average tenure (8.25 years), compared with other certifications and those with no post-professional training.
Another key finding was the timing. Therapists enrolled in the pain certification later in their employment tenure than those in other tracks. The average time from hire to enrollment in the pain certification was 3.67 years, compared with less than one year for sports, orthopedic and manual therapy programs.
This may suggest that more experienced therapists seek out pain training as they encounter more complex cases or as a way to rekindle purpose in their clinical work.
Why Pain Certification Stands Out
The authors suggest several reasons why pain certification may be associated with longer employment.
First, therapists often enter the field through more traditional tracks such as orthopedic or sports. Over time, they may begin to see more chronic pain cases, which require more emotional and cognitive effort to treat.
Many clinicians graduate feeling underprepared to manage persistent pain, and the demands of this patient population may lead them to pursue additional education.
Second, pain neuroscience education has been shown to have a positive impact on clinicians themselves, not just patients.
Studies have found that pain education can improve compassion, reduce provider stress and increase confidence when treating complex cases. This combination may help protect against burnout and contribute to job satisfaction.
One study cited by the authors found that 350 physical therapists who completed a 15-hour pain neuroscience education course reported lower burnout, higher engagement and increased confidence in working with patients with chronic pain six months later.
“Pain education offers more than clinical tools,” said Adriaan Louw, PT, PhD, vice president of faculty experience and pain science director at EIM. “It gives clinicians a renewed sense of purpose at a point in their careers when they’re often searching for deeper meaning in their work.”
Limitations and Future Directions
The study authors acknowledge several limitations. The sample size was small and limited to one organization. It did not assess burnout, job satisfaction or other qualitative factors.
Many personal and systemic variables, such as leadership support, practice setting or clinician motivation, could have influenced the findings.
Still, the results open the door to a deeper exploration of how continuing education affects workforce issues in physical therapy. More research is needed to determine whether other forms of post-professional training have similar impacts, and how employers and educators can support clinicians through career development.
What this Means for the Profession
For employers, the findings suggest that supporting pain certification may improve clinician retention. Encouraging more seasoned therapists to pursue advanced training could help address chronic pain in patients and reduce turnover and preserve institutional knowledge.
“These findings emphasize how important it is for educators to tailor continuing education to a clinician’s stage in their career,” said Louw. “The timing, content and relevance of that education can make all the difference.”