care & love
If you've ever spent time in a hospital, clinic, or rehabilitation center, you've likely witnessed the quiet heroism of therapists. Physical therapists, occupational therapists, and speech-language pathologists move with purpose—adjusting a patient's position, guiding a trembling hand through a daily task, or encouraging a hesitant step forward. What you might not see is the silent cost of that care: the strain in their shoulders after lifting a patient, the ache in their wrists from repeated movements, or the dull throb in their lower back at the end of a 12-hour shift. For therapists, the very acts that heal others can slowly harm their own bodies, thanks to repetitive strain injuries (RSIs) that often go unspoken but deeply felt.
In this article, we'll pull back the curtain on the physical demands of therapy work, explore why RSIs are so common in this field, and share stories from therapists who've lived with these injuries. We'll also dive into practical solutions—from better training to smarter equipment—that can help therapists care for themselves as well as they care for others. Because when therapists are hurting, it's not just their well-being at stake; it's the quality of care they can provide to the patients who depend on them.
Repetitive strain injuries (RSIs) are a group of conditions caused by repeated movements, awkward postures, or prolonged physical stress on the body. They're not just "aches and pains"—they're cumulative, progressive, and can derail careers if left unaddressed. For therapists, whose days are filled with physical tasks that demand precision, strength, and consistency, RSIs are less a risk and more a reality.
Dr. Lisa Chen, a physical therapist with 15 years of experience in a busy urban hospital, knows this firsthand. "I remember my first year out of grad school, I was so focused on helping my patients walk again or reduce their pain that I didn't think twice about my own body," she says. "By the end of that year, I had developed tendonitis in both elbows from repeatedly helping patients lift their legs during exercises. I brushed it off as 'just part of the job'—until it got so bad I could barely hold a coffee mug without wincing."
Dr. Chen isn't alone. A 2023 survey by the American Physical Therapy Association (APTA) found that 76% of physical therapists report experiencing at least one work-related musculoskeletal injury during their career, with 42% reporting chronic issues like lower back pain, rotator cuff strains, or carpal tunnel syndrome. Occupational therapists fare similarly: a study in the American Journal of Occupational Therapy noted that 68% of OTs experience RSIs, often in the shoulders, neck, and hands, due to tasks like helping patients with dressing, grooming, or using adaptive equipment.
Common RSIs in Therapists:
What makes these injuries so insidious is their gradual onset. They don't happen overnight—they build, day after day, as therapists repeat the same movements dozens of times. A single patient transfer might not cause harm, but doing it 8–10 times a day, 5 days a week, for months on end? That's when the body starts to break down.
To understand why RSIs are so prevalent, let's walk through a typical day for a therapist—say, Maria, a 32-year-old occupational therapist working in a skilled nursing facility. Her shift starts at 7:30 AM, and by 8:00, she's already adjusting the electric nursing bed for her first patient, Mr. Thompson, who has Parkinson's disease. He needs the bed raised to a semi-upright position so he can eat breakfast, then lowered again so Maria can help him transfer to a wheelchair. "I adjust beds at least 15 times a day," she says. "Each time, I'm bending over to reach the controls, or leaning across the bed to make sure Mr. Thompson is comfortable. By lunch, my lower back feels like it's been twisted into a knot."
Next, Maria moves to Mrs. Rodriguez, who's recovering from a stroke and needs help with dressing. Maria kneels beside the bed, reaching across Mrs. Rodriguez's body to pull on her shirt, then bends forward to fasten her shoes. "I'm on my knees or hunched over for most of these sessions," she explains. "By mid-morning, my neck and shoulders are screaming."
Then there are the transfers. Mr. Lee, a patient with spinal cord injury, needs to be moved from his bed to a therapy table for exercises. Maria uses a patient lift—a hydraulic device designed to take the strain off caregivers—but even with the lift, she has to position it correctly, secure the sling around Mr. Lee, and guide the lift into place. "If the lift isn't aligned perfectly, I end up compensating by leaning or pulling," she says. "Last month, I strained my shoulder doing that with a patient who was heavier than usual. I took a week off, but it still aches on busy days."
By the end of her shift, Maria has adjusted beds, assisted with transfers, guided patients through exercises, and documented everything in her notes—each task adding a little more stress to her body. "I love my job, but some days I go home and just collapse on the couch," she admits. "I worry about how long I can keep this up."
To put Maria's experience in context, let's look at the average number of physical tasks therapists perform daily, based on interviews with 50 therapists across the U.S. and data from the APTA:
| Task | Average Repetitions per Day | Body Part Most Affected | Strain Risk Level |
|---|---|---|---|
| Adjusting electric nursing bed height/position | 12–18 times | Lower back, shoulders, neck | High |
| Patient transfers (using patient lift or manual assist) | 6–10 times | Lower back, shoulders, knees | Very High |
| Assisting with mobility (e.g., walking, standing) | 8–12 sessions (20–30 minutes each) | Shoulders, arms, lower back | High |
| Manual therapy (e.g., massage, joint mobilization) | 4–6 patients (30–45 minutes each) | Hands, wrists, elbows | Medium-High |
| Documenting notes (typing/writing) | 2–3 hours | Wrists, neck, upper back | Medium |
The "strain risk level" in the table isn't just about how many times a task is done—it's about how it's done. A patient transfer using a well-maintained patient lift with proper training might be low-risk, but if the lift is old, the therapist is rushed, or they haven't been trained to use it correctly, the risk skyrockets. Similarly, adjusting an electric nursing bed with easy-to-reach controls is less straining than one where the controls are on the opposite side of the bed, forcing the therapist to stretch or twist.
Therapists aren't just dealing with physical tasks—they're dealing with a perfect storm of factors that make RSIs more likely. Let's break them down:
Therapists often work with tight schedules, especially in hospitals or clinics where patient loads are high. "I have 6–8 patients a day, each with 30–45 minute sessions," says Dr. Chen. "If one session runs long, I'm rushing through the next to catch up. When you're in a hurry, you cut corners—maybe you don't adjust the patient lift as carefully, or you skip warming up your own muscles before a strenuous transfer. Those shortcuts add up."
There's also the emotional toll of caregiving. "When a patient is in pain or scared, you want to do whatever it takes to help them," Maria says. "I've pushed through my own discomfort to get a patient through a tough therapy session, because I didn't want them to feel like they were a burden. But that's not sustainable."
While tools like electric nursing beds and patient lifts are designed to reduce strain, not all facilities have enough of them, or the ones they have are outdated. "My clinic has one patient lift for 12 therapists," says James. "If someone else is using it, I have to do manual transfers, which are way harder on my back. Or the lift might be broken—we've had one with a stuck hydraulic pump for months, but the budget won't cover a replacement."
Even when equipment is available, training can be lacking. "I was never formally trained on how to use our electric nursing beds," Maria admits. "I just watched another therapist do it once and figured it out. Now I realize I was using the wrong posture—bending at the waist instead of the knees—for years."
Healthcare culture often glorifies "toughing it out." Therapists, like nurses and doctors, are taught to prioritize patient care over their own needs. "Admitting you're in pain feels like a failure," Dr. Chen says. "I hid my elbow tendonitis for months because I didn't want to be seen as 'weak' or 'uncommitted.' By the time I sought treatment, I needed cortisone shots and physical therapy myself."
This mentality also discourages therapists from taking breaks. "If I step away for 10 minutes to stretch, I worry my patients will think I'm slacking," James says. "So I power through, and by the end of the day, my body pays for it."
The good news is that RSIs in therapists are preventable. It takes a combination of individual awareness, workplace support, and better tools—but change is possible. Here are practical steps therapists and facilities can take:
Proper training on equipment like patient lifts and electric nursing beds isn't a "nice-to-have"—it's essential. Facilities should require annual refresher courses on how to use lifts, adjust beds, and perform transfers safely. "My clinic started offering monthly workshops on ergonomics last year, and it made a huge difference," Maria says. "I learned that I'd been using the patient lift with my feet too close together, which was straining my knees. Now I stand with a wide base, and my knees don't ache anymore."
Training should also include body mechanics: how to lift with the legs, not the back; how to keep the spine neutral during transfers; and how to adjust workstations (like therapy tables or computer monitors) to reduce neck and wrist strain.
Therapists shouldn't have to fight for tools that keep them safe. If your facility is short on patient lifts or has outdated electric nursing beds, speak up. "A group of us therapists went to our administrator and showed her data on how many of us were calling out sick with RSIs," Dr. Chen says. "She approved funding for two new lifts and upgraded the beds to ones with remote controls, so we don't have to bend over to adjust them. Now we have fewer injuries, and we're more productive because we're not in pain."
When shopping for equipment, look for features like:
Therapists are experts at telling patients to stretch, rest, and listen to their bodies—but they often forget to follow their own advice. "I now schedule 5-minute 'stretch breaks' between patients," Maria says. "I do shoulder rolls, wrist stretches, and cat-cow poses for my back. It doesn't sound like much, but it keeps the tension from building up."
Other self-care strategies include:
Finally, we need to shift the narrative around therapist well-being. "We need to stop seeing pain as a badge of honor," Dr. Chen says. "If I need help lifting a patient, or if I need to take an extra minute to adjust the bed safely, that shouldn't make me a 'weaker' therapist. It makes me a smarter one—because I'll be able to keep helping patients for years to come."
Facilities can support this by creating a culture where therapists feel comfortable asking for assistance, and by recognizing that therapist health directly impacts patient care. "When I'm not in pain, I'm more present with my patients," Maria says. "I can focus on their progress instead of my own discomfort. That's a win for everyone."
Therapists dedicate their lives to healing others, but they can't do that if their own bodies are breaking down. Repetitive strain injuries are a silent crisis in therapy, but they don't have to be inevitable. With better training, ergonomic equipment like patient lifts and electric nursing beds, and a culture that prioritizes therapist well-being, we can help these caregivers stay healthy, happy, and able to do the work they love.
So the next time you see a therapist adjusting a bed, guiding a patient through a transfer, or celebrating a small victory in therapy, take a moment to appreciate the physical effort behind that care. And if you're a therapist reading this: be kind to yourself. Your body is your most important tool—treat it like one.
After all, the best therapists are the ones who can show up—for their patients, and for themselves.