Environmental Physical Therapy: The Missing Layer in Patient Care

What does the environment have to do with physical therapy? In this episode of the AAOMPT Hands-On, Hands-Off Podcast, Antigone Vesci, PT, DPT, ATC, SCS, FAAOMPT speaks with Philip and Emma to discuss the growing field of environmental physiotherapy and why it goes far beyond making a clinic more sustainable. They explain how physical therapy is connected to the places where people live, move, work, exercise, and recover. From heat waves and air pollution to unsafe walking routes, sustainable healthcare, low-value care, and nature-connected physical activity, this conversation challenges clinicians to think more broadly about patient care. Philip shares how the Environmental Physiotherapy Association began in 2019 and has grown into a global community exploring the relationship between health, environment, society, and physiotherapy. Emma brings a practical clinical lens, encouraging PTs to look beyond individual motivation and ask how the patient’s environment may be shaping movement, adherence, and health. This episode is a must-listen for physical therapists, educators, researchers, clinic owners, and anyone interested in the future of healthcare, planetary health, and more complete clinical reasoning. Learn more about the Environmental Physiotherapy Association and explore their resources through the links in the show notes. YouTube Chapters 00:00 Welcome and guest introductions 02:09 How environmental physiotherapy began 04:26 Beyond making clinics sustainable 07:10 Emma’s lens on climate, health, and movement 10:16 Different “doors” into environmental PT 11:26 Environmental health entering research and guidelines 13:48 Sustainable healthcare and low-value care 17:52 PT’s environmental footprint 20:39 Physical activity and planetary health 24:11 How clinicians can be part of the solution 28:35 Rethinking patient adherence and environment 31:02 Environmental factors already exist in PT models 33:29 Asking “where” patients move 35:02 Body, place, time, and cost 36:52 Is any part of PT not environmental? 39:16 One action clinicians can take Monday 41:07 A practical search exercise for students and clinicians 42:01 Events and future opportunities 43:52 U.S. and international environmental PT momentum 45:18 Closing reflections Guests Filip Maric (PT, PhD): https://en.uit.no/ansatte/person?p_do... Emma Swärdh (PT, PhD): https://ki.se/en/people/emma-swardh#a... Environmental Physiotherapy Association website: https://environmentalphysio.com/. Conceptual A call for a new environmental physiotherapy [https://doi.org/10.1080/09593985.2019...] Advancing the deliberate implementation of the concept of sustainability and its alternatives in physical therapy research, practice, and education [https://doi.org/10.1080/09593985.2024...] What if physiotherapists reimagined physical activity as relational and planetary health-enhancing? [https://doi.org/10.1080/21679169.2026...] Clinical oriented Essentials for sustainable physiotherapy: Introducing environmental reasoning into physiotherapy clinical decision-making [https://fysioterapeuten.no/fagfellevu...] Prescribing active transport as a planetary health intervention [https://doi.org/10.1080/10833196.2021...] From Knowledge to Action: Fostering Advocacy Skills for Planetary Health in Physical Therapy [https://doi.org/10.1093/ptj/pzae130] An international and interdisciplinary framework for nature prescribing in healthcare [https://doi.org/10.1371/journal.pgph....] Physical Therapy Education Education for the Anthropocene: Planetary health, sustainable health care, and the health workforce [https://doi.org/10.1080/0142159x.2020...] A progress report on planetary health, environmental and sustainability education in physiotherapy [https://doi.org/10.1080/21679169.2021...] High consciousness—low application: sustainable development and sustainable healthcare in undergraduate physiotherapy education in Sweden [https://doi.org/10.3389/fpubh.2024.15...] Sustainable development in physiotherapy education: why, what, how. Perspectives of educators in Sweden [https://doi.org/10.1080/21679169.2026...]