Staff shortage in physiotherapy: Figures and ways out

Demand for physiotherapy services is growing, the number of available specialists is not — in many practices, the staff shortage in physiotherapy has long been part of everyday business. Anyone advertising a post today often waits months — and in the meantime treats more patients with the team that is already there. The Therapy Efficiency Report 2026 places solid figures alongside this everyday feeling and shows where capacity lies within an organisation that nobody has to hire.

Staff shortage in physiotherapy: the figures behind the feeling

The report brings the current market data together in one place. It describes a sector working at the limit of its staffing capacity:

• 85.1 per cent of vacancies in physiotherapy could not be filled on a statistical basis as an annual average in 2025 (Tiedemann et al., 2026, KOFA Kompakt 3/2026).
• The skills gap amounted to 12,543 posts over this period.
• Set against this are 50,888 licensed practices in Germany (Soldanski & Schlenz, 2025).
• The part-time rate in the sector is over 50 per cent (Schneidemesser, 2026).

These four figures belong together. The sector is predominantly organised on a small scale: the majority of practices are run as sole proprietorships, with corporations accounting for just under six per cent. A single practice therefore cannot absorb a bottleneck by redistributing staff within a group. Add a high part-time rate and the plannable treatment time per week shrinks even further — no matter how full the appointment diary is.

For practice managers, this means that the bottleneck rarely lies in the rooms and almost never in demand. It lies in therapist time.

The invisible therapist post

The most revealing part of the report is a simple calculation. A typical 20-minute session of remedial exercise does not consist solely of therapeutic work. A considerable share goes on standardisable activities: explaining and demonstrating exercises, counting and correcting repetitions, recording training data by hand.

The report deliberately takes a conservative figure of five minutes per patient. With 20 patients a day, that adds up to over 100 minutes, or almost two hours. Extrapolated to a practice with four therapists, that is nearly eight hours a day — on paper, a full-time post tied up with tasks that nobody needed three years of training for.

That post appears in no staffing plan. It is not advertised, not paid and not filled. It disappears in five-minute portions across the day.

What digital exercise therapy takes over in the treatment process

The report's approach is sober: it is not the therapy that is digitalised, but the standardisable part of it. The division of labour looks like this:

• Stays with the therapist: assessment, therapy planning, manual techniques, complex individual cases, interdisciplinary coordination and the decision as to when a plan needs adjusting.
• The system takes over: exercise instruction, corrective feedback during execution, training control and the documentation of training parameters.

The practical effect is less spectacular than it sounds, and that is precisely why it works: while one patient trains independently with guidance, the therapist is already with the next. Waiting time at the machine becomes treatment time.

How the Pixformance Station addresses this bottleneck

The report comes from Pixformance, and the company describes its own solution in it. The Pixformance Station is a free-standing digital training and therapy unit with over 700 functional exercises and a virtual trainer. An integrated camera tracks 25 body points during training and gives immediate visual and written corrective feedback. Up to four people can work at one station simultaneously, and training documentation runs automatically in the background. For installation, the report cites around six square metres; according to the manufacturer, entry-level leasing starts at 220 euros per month, subject to external approval.

More interesting than the specification list is the comparison with the alternatives that practices actually weigh up:

Criterion	Pixformance Station	Strength machines without feedback	1:1 supervision by therapists	Home exercise app
Correction during execution	via camera and virtual trainer, immediate	none	most precise professionally, but tied to presence	none
Supervision ratio	up to 4 people training simultaneously	supervision required	1:1	no supervision
Training documentation	recorded automatically	manual	manual	depends on the app, usually incomplete
Staffing needed during training	low, patients train independently	medium	high	none
Suitability as a self-pay service	designed as a standalone offering	limited	capped by staff costs	hard to bill
Space required	approx. 6 m² per station	high with several machines	treatment room	none
Individual adaptation for complex findings	within the stored training plans	low	clearly ahead here	low
Adherence outside the practice	can be continued via the web app	not provided for	depends on the exercise sheet	strength of the solution

The table also shows the limits: with complex findings, where every repetition looks different, personal supervision remains superior. Digital exercise therapy pays off where training processes can be standardised — and that is precisely how it creates the time that is missing for the complex cases.

Rehabilitation centres and clinics: documentation as a second lever

In practice, time is the scarcest factor. In rehabilitation centres and clinics, a second one is added: traceability towards payers, referrers and quality auditors. This is where the report starts with training data. Movement quality, repetitions and progress over time are recorded automatically and can be viewed via the online platform. This simplifies documentation, supports quality assurance and provides arguments towards payers — the report explicitly mentions the context of the Blankoverordnung (blanket prescription in the German healthcare system).

For planning the floor space, the report gives concrete benchmarks:

• With two stations, individual and small-group training with up to four people is possible in around 12 to 18 square metres.
• From three stations onwards, group classes can be offered as a standalone training concept.

In clinics, the report sees the benefit above all in integration into existing workflows. Patients complete standardised sessions independently, for example after a manual treatment or between two therapy blocks. Because the training sequences are reproducible, onboarding new staff is also easier, and the quality level remains stable when the team changes. Christoph Oratsch, Head of Therapy at the AUVA Unfallkrankenhaus Klagenfurt, sums up the effect in the report as follows:

"We can treat more patients more easily, with the same staffing resources."

Twelve questions to ask before deciding

The report closes with a self-assessment for decision-makers. It is useful even without any intention to invest, because it sorts out your own bottleneck. Count the points that apply:

1. Skilled staff and capacity: vacancies remain unfilled for longer than three months. Therapists spend a lot of time giving exercise instructions. Utilisation is high, but there is no capacity for new patients.
2. Profitability: a self-pay area is to be set up or expanded. There is a lack of revenue streams beyond statutory health insurance remuneration. Prevention services under § 20 SGB V (the German Social Code provision on prevention) would be of interest.
3. Quality and documentation: therapy outcomes are not yet measured systematically. Documentation is time-consuming and patchy. The quality of exercise execution is to be assured consistently.
4. Future viability: the organisation should be perceived as modern. Patient retention and motivation are important topics. The team should become more attractive in the competition for skilled staff.

The report interprets the total: with zero to four points, the organisation is well positioned, but should check whether potential for optimisation is going unused. Five to eight points indicate considerable potential. With nine to twelve points, there is a high need for action.

What actually happens in the first 60 days

For the roll-out, the report describes three phases: an analysis reviewing premises, needs and patient profile, then pilot operation with training for the whole team and the first training plans, and finally full integration into day-to-day practice, including building up the self-pay services.

Until then, the first step can be taken without any investment at all: note down for a week how many minutes per patient actually go into instruction, correction and documentation. Most teams underestimate this share, and your own figure carries more weight in the discussion than any external projection. Only once that figure is on the table can you seriously decide whether a digital solution, an additional post or a different appointment structure is the right lever.