This annual list of the best physical therapy franchises was revised and updated on September 20, 2023.

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Physical therapists support people with ongoing medical conditions through physical treatments, rather than drugs or surgery. This covers a wide range of practices, including exercise regimes and massage.

The most prominent groups of clients for the industry are those recovering from accidents, who need help in returning their bodies to working function, and those with long-term physical musculoskeletal conditions, for whom physical therapy can provide a relief from pain and greater capacity within their own bodies. It extends beyond highly visible injuries into areas such as speech, language, and hearing, and beyond direct physical treatments into educational and recreational activities that can support recovery.

The physical therapy industry in the United States is currently worth $48.8 billion. The industry has been growing steadily for the past decade, with annualized market growth of 1.6% over the past five years. It employs over 576,000 staff in 125,000 businesses.

Like many industries, physical therapy suffered a setback in 2020 thanks to the Covid pandemic, as the economic impact and the challenges of seeing clients in person took nearly four billion dollars of industry revenues, with 54% of physical therapists seeing fewer patient visits. But physical therapy is a high priority for the people who make use of it, reducing pain, improving mobility, and allowing them to live their lives in ways that are impossible without its benefits. Clients were therefore fast to return. In 2021, the industry not only returned to but exceeded its previous revenues, and it is now stronger than ever. The number of businesses is growing by 1.5% per year.

In the long term, the industry is likely to see strong growth continue. An increasingly elderly population means that more and more Americans suffer from physical ailments that benefit from physical therapy. 36.1% of physical therapy patients are over 65 years old, and this proportion is likely to grow as the population ages.

The Covid pandemic may create an increase in revenues over coming years, as people seek help with the long-term effects of the disease. The growth in telemedicine has also helped the industry, as appointments over the phone and video allow more patients to access support and therapists to develop new, more diverse revenue streams. 47% of therapists reported using these sorts of appointments in July 2020, compared with only 2% pre-pandemic, and the lessons learned from the pandemic are likely to have long-term effects on the industry.

Shifts in personal income, government funding, and medical coverage can all cause fluctuations in the industry, and this has historically led to some volatility. Current conditions are favorable, not only because of changes in the population’s needs but because of growing awareness of the benefits of physical therapy, which are leading more people to take up treatment. For some, this represents access to the help they need for the first time. For others, it’s a way to get away from drug treatments and their negative side effects – for example, 41% of chiropractic patients are looking for drug-free pain relief. 80% of Americans will experience back pain at some point in their lives, so physical therapy can provide benefits for almost everyone.

The Medicare and Medicaid programs now provide a significant proportion of physical therapy revenues. Varying rulings, interpretations, and discretionary payment systems around these payments can therefore affect revenues for physical therapy businesses, and it’s worth being aware of how this might affect your target client base, as well as keeping an eye on the shifting politics around medical funding. The levels of price caps by both private and public insurers may affect available revenues – private insurers remain the industry’s biggest customers.

Physical therapy businesses generally do best in metro areas, where dense populations with a variety of needs provide a strong customer base. While office workers might not be putting obvious strains on their bodies, poor posture can do nearly as much damage as a workplace accident, and so there are opportunities to serve patients across the working population. Rules for what physical therapists can offer without a referral vary from state to state, so it’s worth checking with the American Physical Therapy Association to find out the rules where you’re thinking of starting a franchise.

Like many industries employing staff with specialist skills, wages are the biggest cost for physical therapy businesses, absorbing nearly half of revenues. Workforce shortages and the associated staffing costs are creating pressures on businesses, but trying to cut costs in this area isn’t a great solution. Finding the right staff, people who know the medicine and can work well with clients, is critical to a therapy business’s success.

There can be some value in specialization. Musculoskeletal conditions account for 44.7% of revenues, and so dealing with these conditions is the most reliable way to start building up customers. That still leaves 55% of potential revenues from other customers, so it’s important to consider a broad spread of services that won’t leave money on the table.

This is a fragmented industry, in which the top 50 competitors between them have only 29% of revenues, so there’s plenty of market space for franchised outlets. And with demand growing due to demographic factors, it’s likely to remain profitable for the near future.

Franchise Chatter’s Top Physical Therapy Franchises of 2023

1.  Fyzical Therapy & Balance Centers

Fyzical Therapy & Balance Centers takes a holistic approach to help people of all ages achieve a better quality of life by evaluating and treating a wide range of muscle, joint, and neurological conditions. Their therapists rely on the most relevant therapeutic techniques, state-of-the-art technologies, and effective communication to achieve great results.

One of the most important aspects is the diagnosis process, which Fyzical therapists accomplish by using the BODYQ holistic health assessment. Services include dizziness/vertigo treatment, orthopedic rehabilitation, balance therapy, fitness and wellness, occupational therapy, neurological rehabilitation, pelvic therapy, audiology, and a range of specialty services.

Founded by Jim Abrams in 2012, headquartered in Sarasota, Florida, and franchising since 2013, the number of locations has been climbing steadily in recent years from just 20 in 2013 to the current total of 473 (up from the previously reported total of 431), of which 57 are company-owned and all are located in the US.

2.  ApexNetwork Physical Therapy

ApexNetwork Physical Therapy helps people find lasting relief from the aches and pains that keep them from enjoying life to the fullest. Their expert therapists work with patients closely to collaboratively develop a customized treatment plan to address identified issues and desired goals.

The most common types of specific conditions treated include arm pain, neck pain, shoulder pain, head pain, hand pain, back pain, lower-back pain, hip pain, leg pain, knee pain, ankle pain, and foot pain. For older people who live with the constant fear of falling, the company offers its AgeStrong program to assess fall risk through balance and mobility assessments, then customizes a treatment plan to stabilize joints and improve gait patterns.

Founded by three physical therapists who were friends in Highland, Illinois in 1999 and franchising since 2008, the number of locations has risen in recent years from 17 in 2013 to the current total of 90 (up from the previously reported total of 86), of which 61 are company-owned and all are located in the US.

3.  Physical Therapy Now

Physical Therapy Now provides clients with compassionate, comprehensive care to help them move past chronic pain to start feeling better. Whether it’s an injury (sports, work, automobile), chronic condition, or post-surgery recovery, PTN offers a wide range of treatments to help.

Services included exercise therapy, pain management, concussion therapy, whiplash therapy, manual therapy, massage therapy, stretch therapy, muscle strain/sprain therapy, functional capacity evaluations, laser therapy, home exercise programs, occupational therapy, car accident injuries, stroke therapy, TBIs (traumatic brain injuries), and FCE (functional capacity evaluation). Additional conditions they can treat include herniated discs, sciatic nerve pain, tennis elbow, and joint problems.

Some locations offer extended hours from 9 a.m. to 8 p.m.

Founded by occupational therapist Andres Zapata in Florida in 2011 and franchising since 2015, the number of locations currently stands at 45 (up from the previously reported total of 43), of which six are company-owned and all are located in the US.

An Important Note About Our Methodology

The franchises on this list were ranked according to the number of units in the franchise system. If you are a prospective franchisee searching for franchise opportunities that meet or exceed certain performance benchmarks for sales, profits, and return on investment, please check out this list of America’s Most Lucrative Franchises.

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