Current Practice Issues

The Academy of Orthopaedic Physical Therapy continually monitors scope of practice issues relevant to orthopaedic physical therapy. The following resources and references are available through the American Physical Therapy Association.

Direct Access

Although all 50 states, the District of Columbia, and the US Virgin Islands allow some level of direct access to physical therapy services, many state and local restrictions impact patients’ ability to access physical therapy services. APTA resources for providers and consumers: Direct Access.


Diagnostic and procedural imaging within the context of PT practice is an area of rapidly growing interest within the profession. Whether through specific legislative change or interpretation of existing practice act language, PTs are now referring patients for imaging in an increasing number of jurisdictions. For more information, multiple resources are available elsewhere on this site under the Imaging Special Interest Group at and through APTA’s Imaging web page.

Dry Needling

Dry Needling continues to be a scope of practice issue many physical therapists and components are being challenged to defend. Check out the up to date information and useful resources related to dry needling in physical therapist practice, developed by the APTA: Dry Needling.


The Academy of Orthopaedic Physical Therapy along with the APTA has developed valuable information and resource materials related to manipulation in physical therapy practice. Who is qualified to perform spinal manipulation? What are the risks for physical therapists performing manipulation techniques? What are best practices for teaching manipulation in physical therapy education programs? For these answers and more, click here.