Physical therapy specialties: your certification options

Physical therapy is a dynamic and evolving healthcare field that blends cutting-edge science and clinical expertise with therapeutic, hands-on techniques. Professionals in physical therapy deliver essential rehabilitation services, enhancing patients’ movement, functional ability, and overall quality of life. With an average salary of over $100,000 for physical therapists, the field offers a lucrative and patient-centered career path for medical professionals.

Within physical therapy, clinicians have the opportunity to move from general practice to specialty physical therapy. Specializing allows physical therapists to focus their expertise in areas such as sports physical therapy, neurology, or geriatric medicine. By obtaining board certification in a specialty area, practitioners target their work with particular populations, specific health conditions, or unique care environments. Certifications provide professional recognition and can unlock benefits like higher earning potential, expanded career options, and increased professional mobility.

The American Physical Therapy Association (APTA) identifies 10 board-certified specialties for physical therapists, encompassing practice with older adults, oncology patients, and other niche areas. Each specialty physical therapy certification requires the completion of advanced examinations and validation of experience to ensure therapists are qualified to treat designated patient populations or medical conditions. After passing your National Physical Therapy Examination (NPTE) and gaining your license, pursuing specialty certification becomes possible.

This article includes an overview of each APTA-recognized certification in physical therapy, such as the Orthopaedic Clinical Specialist (OCS) credential, along with concise descriptions and additional requirements. Please note that full certification titles and related American Board of Physical Therapy Specialties (ABPTS) acronyms are used below. However, be aware that acronyms are no longer used for official designation and are included for convenience.

How do I specialize as a physical therapist?

There are certain minimum requirements all physical therapists must complete in order to gain a specialist certification.

To become certified, you’ll first need to receive your Doctor of Physical Therapy (DPT) from an accredited university. The Federation of State Boards of Physical Therapy (FSBPT) distributes the National Physical Therapy Examination for physical therapists (NPTE-PT), a 5-hour exam that covers the foundational knowledge needed to practice as a physical therapist. After passing this exam, you must gain a physical therapy license in your state.

The general requirements for specialization include one of two options:

• Submit evidence of 2,000 hours of direct patient care as a licensed physical therapist in the U.S. in the chosen speciality, with at least 25% or 500 hours of experience gained in the last three years.
• Complete an APTA-accredited post-professional clinical residency in the specialty area. Residencies must be completed within 10 years of applying for a specialty.

All specialities require a separate examination and the payment of both an application and exam fee. Certification fees and deadlines can be found on APTA’s website. Application cycles begin in May and continue into June of the following year. Exams are administered at PSI Testing Centers across the U.S.

Applicants must also sit and pass a written examination assessing the applicant’s ability to apply advanced knowledge and clinical skills. Specific skills, knowledge areas, and exam content outlines are included in the official Description of Specialty Practice (DSP) book for each specialty.

Physical therapists can apply for more than one speciality, but the APTA strongly recommends doing so in separate years. The amount of time needed to prepare for and maintain certification can be demanding, as each certification requires its own application, set of clinical hours, and other application requirements. It is best to stagger this process to ensure full completion of each requirement.

Many specialties also demand additional steps to be eligible for certification, which are highlighted in the list of physical therapy specialties below.

Cardiovascular and Pulmonary (CCS)

CCS specialists are dedicated to evaluating and treating individuals with complex heart and lung conditions, focusing on both post-surgical rehabilitation and the long-term management of chronic cardiovascular or pulmonary diseases.

Additional CCS requirements include:

• Certification in Advanced Cardiac Life Support (ACLS) by the American Heart Association
• Submission of a data analysis project or case report

Clinical Electrophysiology (ECS)

ECS-certified therapists are highly trained in clinical electrophysiology, the science of tracking electrical signals within the body to locate and address muscle and nerve problems. These specialists utilize advanced electrical testing and therapeutic technologies, including electromyography (EMG) and nerve conduction studies (NCS), to diagnose neuromuscular disorders and develop targeted interventions for patients with nerve or muscle impairments.

Additional ECS certification requirements include:

• Submit a comprehensive list of individual learning experiences related to the practice of clinical electrophysiologic physical therapy, completed within the past 10 years
• Submission of three detailed patient reports:
  • A report describing a patient with proximal level compromise, representing a radiculopathic process.
  • A report focusing on a patient with peripheral nerve entrapment.
  • A report on addressing a patient’s condition with a polyneuropathic process.
• Submission of a log documenting the most recently completed 500 electrodiagnostic examinations, including both EMG and NCS procedures, conducted within the last ten years

Geriatrics (GCS)

GCS therapists specialize in caring for older adults by addressing age-related conditions such as arthritis, osteoporosis, balance impairments, and cognitive decline. Through GCS certification, these specialists are trained to develop customized physical therapy programs that help older adults maintain mobility, independence, and a high quality of life.

There are no additional eligibility requirements needed to pursue GCS certification in physical therapy.

Neurology (NCS)

NCS-certified specialists, recognized through NCS certification, provide expert NCS physical therapy for individuals experiencing neurological disorders such as stroke, Parkinson’s disease, multiple sclerosis, and spinal cord injuries. Utilizing their advanced neurology credentials, NCS physical therapy practitioners design targeted rehabilitation interventions aimed at restoring movement, improving coordination, and maximizing functional independence.

Earning the NCS certification does not require any additional prerequisites beyond those needed for general certification.

Oncology

Oncology-certified therapists assist patients in managing the physical effects of cancer and its treatments, including fatigue, lymphedema, and muscle weakness. Through specialized oncology physical therapy interventions, these professionals support recovery, enhance functional abilities, and improve quality of life both during and after comprehensive cancer care.

Additional oncology certification requirements for oncology specialists include:

• Submission of a case report that demonstrates advanced practice in oncologic physical therapy for a patient treated within the past three years.

Orthopaedics (OCS)

OCS physical therapy specialists are dedicated to preventing disability and delivering essential rehabilitative care for patients experiencing musculoskeletal and neurovascular dysfunction. By leveraging advanced orthopedic knowledge, providers with OCS certification offer corrective, adaptive, and preventative management strategies to help patients achieve optimal functional outcomes.

Currently, there are no supplemental orthopaedic certification requirements for pursuing OCS certification. Starting in 2027, candidates for OCS physical therapy credentials will be permitted to fulfill either 2,000 direct patient care hours or provide evidence of observational or mentored patient care hours.

Pediatrics (PCS)

PCS therapists specialize in treating infants, children, and adolescents with a wide range of developmental, neurological, or musculoskeletal conditions. Utilizing play-based and family-centered PCS physical therapy techniques, these practitioners promote movement skills and enhance participation in daily activities tailored to pediatric needs.

There are no additional requirements for a certification in pediatrics.

Sports (SCS)

SCS-certified therapists are experts in athletic physical therapy, specializing in the prevention, assessment, and rehabilitation of sports-related injuries for athletes at all levels. Through SCS certification, these specialty physical therapy professionals integrate advanced performance enhancement strategies with evidence-based rehabilitation techniques. Their goal is to ensure a safe and effective return to sport for every athlete, leveraging the latest in sports therapy research.

Additional requirements for SCS certification in specialty physical therapy:

• Current CPR certification
• Submission of proof demonstrating up-to-date knowledge in national First Responder standards and Emergency Cardiovascular Care (ECC) guidelines, confirming expertise in the acute management of sports injuries and illnesses. This requirement may be satisfied through approved coursework or certification.
• Completion of 100 hours of direct athletic patient care, with at least 50% of these hours involving experience with contact sports.

Women’s Health (WCS)

WCS therapists address conditions unique to women’s health, including pelvic floor dysfunction, pregnancy-related musculoskeletal issues, and postpartum recovery. They use specialized interventions to restore function, reduce pain, and improve quality of life.

Additional women’s health certification requirements:

• A case reflection demonstrating specialty practice in women’s health within the last three years.

Wound Management

These specialists treat complex wounds, burns, and skin injuries using advanced dressings, debridement, and other therapeutic techniques. Their goal is to promote healing, prevent infection, and restore skin integrity.

Additional wound management physical therapy certification requirements:

• CPR certification
• A case report from the last three years demonstrating specialty practice in wound management and physical therapy
  
  

Advanced Proficiency Pathways for Physical Therapy Assistants

Specialization options are also open to physical therapy assistants (PTAs), another popular career path within physical therapy. The APTA offers PTA Advanced Proficiency Pathways in eight key areas:

• Acute Care
• Cardiovascular and Pulmonary
• Geriatrics
• Neurology
• Oncology
• Orthopedics
• Pediatrics
• Wound Management

The Advanced Proficiency Pathways is the premier program for APTA members to gain specialized training and skills. To become a licensed PTA, applicants must pass the NPTE exam for physical therapist assistants, the NPTE-PTA. Speciality certifications are granted to licensed professionals based on additional assessments in the fields listed above.

The requirements for becoming a specialized PTA include being an APTA member in good standing, having a current PTA license, and completing the following courses in the APTA Learning Center:

• Information on APTA’s Revised Code of Ethics for the Physical Therapist and Standards of Ethical Conduct for the Physical Therapist Assistant
• Leading the Team: A Practical Guide to Working with PTAs
• Professionalism Module 1: Introduction to Professionalism

The required courses are free to APTA members, but enrollment and portfolio review costs apply.

Wrapping up

Physical therapy specializations open a whole new world of possibilities for seasoned PT professionals. By pursuing specialty physical therapy, physical therapists can focus their careers on areas such as sports medicine, women’s health, orthopedics, pediatrics, and more. This allows you to tailor your practice to your passions and develop advanced skills in your chosen specialty field.

After successfully passing the NPTE exam, securing your license, and completing required clinical hours and additional requirements, you’ll be on the path to becoming a specialist in your preferred area of physical therapy. For further details about the NPTE-PT and NPTE-PTA exams, visit Achievable’s exam course pages. Specialty physical therapy offers rewarding opportunities to deepen your expertise and make a lasting impact on your patients’ lives.