Environmental Physiotherapy: A New Lens for Patient Care

In this episode, Antigone Vesci, PT, DPT, ATC, SCS, FAAOMPT speaks with Filip Maric, PT, PhD and Emma Swardh, PT, PhD, as they introduce the field of environmental physiotherapy and invite clinicians to think beyond the walls of the clinic.Rather than limiting sustainability to recycling, energy use, or clinic operations, environmental physiotherapy asks a deeper question: What do health, environment, society, and physical therapy have to do with each other?The conversation explores how environmental factors influence patient care, including heat waves, air pollution, unsafe walking routes, access to movement spaces, health behavior, physical activity, and adherence. Philip and Emma also discuss the role of physical therapy in sustainable healthcare, including prevention, health promotion, lower-footprint care, and avoiding unnecessary or low-value interventions.For clinicians, the takeaway is practical: start asking better questions about the patient’s environment. Where are they moving? What has changed around them? Is their environment helping or limiting their recovery?This episode offers a timely and thought-provoking look at how physical therapy can contribute to human health, planetary health, and more complete clinical reasoning.Key Takeaways:Environmental physiotherapy is broader than clinic sustainability.The patient’s environment can influence movement, adherence, pain, access, and recovery.Physical therapy may be a lower-footprint healthcare option compared with more resource-intensive pathways.Prevention, health promotion, and avoiding unnecessary care are part of sustainable healthcare.Clinicians can start immediately by asking more curious questions about where and how patients move.Physical activity can support human health and planetary health, but context matters.Links and contacts:Filip Maric (PT, PhD), Associate Professor in Physiotherapy, Healthcare Innovation and Sustainability at UiT The Arctic University of Norway. Founder and Executive Chair of the Environmental Physiotherapy Association. https://en.uit.no/ansatte/person?p_document_id=706687 Emma Swärdh (PT, PhD), Assistant Senior Lecturer at Karolinska Institutet, Stockholm, Sweden and member of the Environmental Physiotherapy Association executive committee. https://ki.se/en/people/emma-swardh#about-me Environmental Physiotherapy Association website: https://environmentalphysio.com/. The one-stop shop for all things environmental physiotherapy. Including all the latest research publications, resources for education and clinical practice, information on past, ongoing and upcoming events, and a regular blog covering the breadth of environmental physiotherapy. The website will also lead you to those of other key organisations in the field like the Planetary Health Alliance, the Sustainable Development Solutions Network, and many more.Publications of note: ConceptualMaric, F., & Nicholls, D. (2019). A call for a new environmental physiotherapy - An editorial. Physiotherapy Theory and Practice, 35(10), 905–907. https://doi.org/10.1080/09593985.2019.1632006 Maric, F., Plaisant, M., & Richter, R. (2025). Advancing the deliberate implementation of the concept of sustainability and its alternatives in physical therapy research, practice, and education. Physiotherapy Theory and Practice, 41(6), 1239–1253. https://doi.org/10.1080/09593985.2024.2395486 Swärdh, E., & Hagströmer, M. (2026). What if physiotherapists reimagined physical activity as relational and planetary health-enhancing? – Editorial. European Journal of Physiotherapy, 28(1), 1–4. https://doi.org/10.1080/21679169.2026.2610151 Clinically orientedMaric, F., Groven, K.S., Banerjee, S. & Dahl-Michelsen, T. (2021). Essentials for sustainable physiotherapy: Introducing environmental reasoning into physiotherapy clinical decision-making. Fysioterapeuten, 88(4), 54 – 58. https://fysioterapeuten.no/fagfellevurdert-sustainable-physiotherapy/essentials-for-sustainable-physiotherapy-introducing-environmental-reasoning-into-physiotherapy-clinical-decision-making/1317Toner, A., Lewis, J. S., Stanhope, J., & Maric, F. (2021). Prescribing active transport as a planetary health intervention – benefits, challenges and recommendations. Physical Therapy Reviews, 26(3), 159–167. https://doi.org/10.1080/10833196.2021.1876598 Swärdh, E., & Maric, F. (2024). From Knowledge to Action: Fostering Advocacy Skills for Planetary Health in Physical Therapy. Physical Therapy, 104(11). https://doi.org/10.1093/ptj/pzae130 Struthers, N. A., Zecevic, A. A., Stanhope, J., Breed, M. F., Gittings, L., Gunz, A., Wagenfeld, A., Birmingham, T., Kothari, A., & Maric, F. (2026). An international and interdisciplinary framework for nature prescribing in healthcare: A modified Delphi study. PLOS Global Public Health, 6(4), e0006361. https://doi.org/10.1371/journal.pgph.0006361 PT educationBarna, S., Maric, F., Simons, J., Kumar, S., & Blankestijn, P. J. (2020). Education for the Anthropocene: Planetary health, sustainable health care, and the health workforce. Medical Teacher, 42(10), 1091–1096. https://doi.org/10.1080/0142159x.2020.1798914 Maric, F., Chance-Larsen, K., Chevan, J., Jameson, S., Nicholls, D., Opsommer, E., Perveen, W., Richter, R., Stanhope, J., Stone, O., Strimpakos, N., Vieira, A., Williams, M., Zuber, S., & Söderlund, A. (2021). A progress report on planetary health, environmental and sustainability education in physiotherapy – Editorial. European Journal of Physiotherapy, 23(4), 201–202. https://doi.org/10.1080/21679169.2021.1932981 Swärdh, E., Brodin, N., Palstam, A., & Pettersson, A. (2024). High consciousness—low application: sustainable development and sustainable healthcare in undergraduate physiotherapy education in Sweden. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1509997 Swärdh, E., Palstam, A., Pettersson, A., & Brodin, N. (2026). Sustainable development in physiotherapy education: why, what, how. Perspectives of educators in Sweden. European Journal of Physiotherapy, 1–17. https://doi.org/10.1080/21679169.2026.2693304