Virtual physical therapy: what works and what doesn't?

Both patients and clinicians are getting more comfortable with telehealth and virtual physical therapy (PT). This is good news for employers and health plans looking to reduce costs without compromising outcomes.

I’m Megan Hill, PT, DPT, Director of Clinical Specialists at Sword Health. I hold a Doctor of Physical Therapy degree and have dedicated my career to helping people recover from musculoskeletal conditions. When I tell people that I work for a digital MSK therapy provider, I’m often met with curiosity, and sometimes skepticism, especially from fellow clinicians.

What is virtual PT and why does it matter?

Virtual PT uses technology to deliver physical therapy remotely. Instead of traveling to a clinic, members connect through a digital platform that guides their exercises, tracks their movements, and keeps them connected to a licensed Doctor of Physical Therapy.

This matters because MSK conditions are the number one driver of healthcare costs in the U.S.². Traditional PT has serious challenges. Half of patients drop out after just four sessions³. Many face long wait times or live too far from a clinic to access consistent care⁴.

Virtual PT removes those barriers. It brings care to people when and where they need it most.

Why virtual PT companies are growing

Virtual PT companies are thriving because they meet people where they are. With busy lives and rising costs, people want recovery that fits into their routines.

Sword Health leads this transformation. Thrive, our Digital Physical Therapy program is clinically validated to deliver outcomes equal to or better than in-person care². Members experience pain relief, functional improvement, and even mental health benefits such as reduced anxiety and depression².

These results, paired with convenience, explain why health plans and employers increasingly cover virtual PT at no cost to members.

Benefits of virtual physical therapy

Here are three key advantages that always help people understand how powerful Sword Thrive can be for them:

1. Accessibility and convenience. With Sword, 50% of sessions occur after hours and 20% on weekends, which means you can work on your personalized care program at any time that suits your schedule⁵.
2. Personalized care. Every program is designed by a Doctor of Physical Therapy. The Digital Therapist provides real-time feedback to ensure correct form and safe progress². You get this premium level of care from the comfort of home.
3. Better outcomes. Sword members see up to 70% lower surgery intent, 50% fewer anxiety symptoms, and 64% fewer depression symptoms².

These benefits make recovery not only easier, but more effective.

Not all virtual MSK solutions work so well

There are three main pillars that have to be met to deliver high-quality MSK care virtually:

1. Programs must be tailored to the member’s needs and be adequately supervised.
2. Results only happen if the members actually do their exercises and do them correctly.
3. Education and behavioral coaching are essential to achieving lasting changes.

Why Virtual PT works better for so many people

In-person PT often doesn’t fit modern life. So many people who start PT struggle to find the time to schedule and commute to an in-person clinic appointment while juggling their family and work commitments. The result is people often quit within weeks, or they lose momentum with their recovery program because it’s too hard to keep up.

That drop-off shows in the data: half of patients stop PT after the first month³. Sword, by contrast, has an 81% completion rate⁶.

When people stick with their plan, they recover better. Sword members report being pain-free at program completion 67% of the time, even if they began with moderate to severe pain⁷. Many also reduce or stop pain medication².

For parents, professionals, and rural residents, virtual PT isn’t just easier. It’s more effective.

Three questions to ask if you’re considering digital therapy

When I speak to people considering virtual PT, I always urge them to consider these three questions before making a decision on which provider to chose.

1. Is the program designed and supervised by a licensed physical therapist?

It might sound obvious, but virtual MSK programs need a real physical therapist managing care to get the best results.

We have years of clinical training in diagnosing and treating musculoskeletal conditions. We understand underlying patterns to diagnose referred pain or other conditions as early as possible, and we monitor every patient’s progress to make sure they’re getting the best treatment possible.

At Sword, members only ever interact with a physical therapist who is there every step of the way, from diagnosis to recovery.

2. Does the member and the PT both get feedback on performance and progress?

Feedback on how the body is moving is critical for effective physical therapy.

We can’t do our jobs properly unless we understand exactly how someone is moving and their subjective experience of the session (Was it painful? Was it difficult? How are they feeling?).

In the clinic, the physical therapist is able to see how their patient’s body is moving with their own eyes. We’re trained to identify movement patterns that are causing issues or indicative of problems and adjust our patient’s form accordingly.

When they go home from the clinic, patients often leave with instructions on a piece of paper. Those paper instructions may not even make it out of a purse, and even when they are followed, we have no idea if the person is performing exercises correctly. This means the recovery process can be slow.

At Sword, we use Phoenix, the world’s first AI Care Specialist. Each member who enrolls in Thrive receives a Sword kit that includes a tablet equipped with Phoenix – technology to provide realtime biofeedback. The motion-tracking is even more precise than the human eye, allowing Phoenix to give the member real-time feedback on how they’re doing. If a member performs an exercise incorrectly, our virtual Digital Therapist will correct their form. This feedback not only helps members learn new movement patterns, but it also helps them stay accountable and stick with their program.

This tracking also gives the physical therapist live feedback on exactly how a member is performing every stretch and bend, and we use that feedback to evolve their program and catch any red flags that come up through the course of their treatment.

Since joining Sword, I’ve been amazed at how much information I’m getting about how my members are performing. I can progress their virtual programs with more certainty and have seen members start feeling better quickly.

There are many solutions out there that use basic video to guide people through exercise programs. While they may be good for helping people see how to do an exercise, they don’t tell you if you are doing them correctly, and the clinician on the other end is flying blind. Just like that piece of paper from the clinic, they aren’t going to get you the results you need, especially for serious chronic or post-surgical issues.

3. Does the program combine education and coaching?

I became a PT after I experienced the benefits of great physical therapy first-hand.

I had just injured my knee running the Chicago Marathon. I love to run, and this injury was devastating. My physical therapist helped me get back on track - not just by prescribing me an exercise program, but by helping me understand why I got injured in the first place, giving me the tools to prevent it in the future, and making me believe that I had it in me to make a full recovery.

I’m grateful to this day for her guidance and support - and she has inspired me to become the PT I am today.

Great physical therapy is more than just an exercise program - because pain is complex and healing involves both body and mind.

Physical therapists are trained to incorporate pain education into their treatments, helping patients understand that hurt does not equal harm, their bodies are strong and adaptable, and that they do not need fixing - they are the most important factor in their own rehabilitation.

The words we use to empower our patients are critical.

Discussing pain from a less-trained perspective can result in increased fear, decreased belief in one’s ability to heal, and avoidance of activities - all of which can contribute to the persistence and aggravation of pain.

At Sword, our PTs develop coaching programs that incorporate education as well as motivational techniques. These programs are specific to each member and are adjusted as they progress along their journey, so they don’t just get better, they stay better.

Is virtual PT right for you?

Virtual PT helps with many conditions, from back pain to post-surgical recovery. It is safe, effective, and clinically validated².

Most importantly, it adapts to your life. If you work full time, care for kids, or live in a rural community, this is therapy that works on your terms.

And the cost? Many people find Sword’s program is already covered by their health plan at no cost. That made the choice simple for me.

Virtual PT with Sword Health combines proven outcomes, expert support, and ease of access. You don’t need to compromise results to recover at home.

Want to learn more about Sword's virtual physical therapy? Sword’s care programs may already be covered in your health plan at $0 cost.

About the author: Megan Hill, PT, DPT

Megan Hill, Doctor of Physical Therapy, is a licensed physical therapist focused on musculoskeletal rehab and chronic pain management. She dropped her plans to go to law school for physical therapy after a knee injury from the Chicago Marathon left her in need of rehab, and she hasn’t looked back since. She’s on a mission to empower people to manage their health through exercise, education and coaching, rather than relying on passive approaches.

Megan earned a Doctor of Physical Therapy degree from the University of Illinois at Chicago (UIC). She also holds a Bachelor of Arts degree in psychology from Duke University and is a certified running coach.

Megan lives in Denver, Colorado, where she spends every spare second running, biking, hiking, sailing and stand up paddleboarding with her husband, Layton, and dog, Ollie.