A 2025 Study Swabbed 39 Surfaces in a Sports Medicine Clinic. Here's What Clinic Owners Should Take From It

TL;DR

• A March 2025 peer-reviewed study in Microorganisms found one bacterial genus, Ralstonia pickettii, dominating nearly 80 percent of sampled surfaces in an outpatient sports medicine clinic before a targeted cleaning program was introduced. Read the study
• A separate PLOS ONE pilot study of an outpatient rehabilitation clinic found Staphylococcus on more than a quarter of all bacterial DNA recovered from 40 sampled surfaces, with recumbent bike seats and handlebars among the dirtiest spots tested. Read the study
• Every one of 10 chiropractic treatment tables sampled in a published infection control study carried gram-positive organisms, including confirmed MRSA on at least one table, before disinfection. Read the study
• OSHA's Bloodborne Pathogens Standard applies to PT, chiro, and sports medicine practices with employees who have reasonably anticipated exposure to blood, and 2025 maximum penalties run up to $16,550 per serious violation and $165,514 per willful or repeat violation. See OSHA's penalty schedule
• UV-C is a genuinely strong supplemental fit for shared, non-porous rehab equipment between patients, but it does not replace required chemical disinfection, sterilization, or your clinic's written infection control protocol.

A 2025 Study Sampled 39 Surfaces in a Sports Medicine Clinic. One Bacterium Dominated Nearly 80 Percent of Them

Researchers publishing in the peer-reviewed journal Microorganisms in April 2025 set out to characterize the microbiome of an outpatient sports medicine clinic and test whether a microbiome-informed cleaning program could actually change what was living on its surfaces. They swabbed 39 high-touch sites: therapy tables, treadmill and bike handles, weights, ultrasound gel bottles, massage cream containers, and general gym apparatus used across a rotating caseload of patients. Before the intervention, a single bacterial genus, Ralstonia pickettii, made up nearly half of all bacterial DNA recovered clinic-wide and was present on roughly 79.5 percent of the surfaces tested, an unusually lopsided level of dominance for an indoor clinical environment. (Microorganisms, 2025)

The researchers also found that patients made significantly more surface contact than staff during a visit (p<0.0001), which matters for a clinic model built around patients independently using recumbent bikes, resistance bands, and exercise balls between formal treatment sessions. After the clinic adopted a cleaning protocol designed around the microbiome data rather than a generic wipe-down schedule, R. pickettii's share of the total bacterial community dropped from roughly 50 percent to about 4 percent, and the overall bacterial community became measurably more diverse and more typical of a normal indoor environment rather than one genus crowding everything else out. Total bacterial load did not change significantly, but the composition did, which the authors describe as evidence that a "microbiome-specific cleaning strategy was successful in diversifying the microbiome and reducing ecological dominance." (Microorganisms, 2025)

That is not an outbreak story. It is arguably more useful than one: a controlled, published, 2025 look inside a real working sports medicine clinic showing that a specific, identifiable organism can quietly take over shared equipment surfaces, and that the composition of what is on your tables and handles is something you can actually measure and change with the right protocol.

Why This Matters: The Data Behind the Headline

This finding does not stand alone. A companion pilot study published in PLOS ONE sampled 40 surfaces across a Midwestern outpatient physical therapy clinic and found Staphylococcus accounted for about 28 percent of recovered bacterial DNA, more than any other genus. The highest bacterial loads by far were on the recumbent bike seat and handlebars, the floor near the sink, and the earpiece and mouthpiece of the clinic phone. Notably, the researchers found that how often a surface was touched did not predict contamination level nearly as well as what the surface was made of: porous surfaces carried significantly more bacterial DNA than non-porous ones (p=0.0066). A shared foam pad or fabric-covered item can hold more bacteria than a hard surface that gets touched far more often. (PLOS ONE, 2023)

Chiropractic offices show a similar pattern on the equipment closest to actual patient contact. In a published infection control assessment, researchers swabbed 10 chiropractic treatment tables and found gram-positive organisms, including Staphylococcus epidermidis, S. saprophyticus, and confirmed methicillin-resistant Staphylococcus aureus (MRSA), on every single table tested. The same study found that simple disinfection, either 70 percent isopropyl alcohol wipes or a standard EPA-registered sanitizing wipe, eliminated the detectable pathogens from tested tables afterward, and it flagged that documented hand hygiene compliance among healthcare providers can run below 50 percent in clinical settings, a gap that directly affects what gets transferred to the next surface a provider touches. (PMC, chiropractic treatment table study)

Sports medicine and athletic training settings, which share equipment types and patient flow patterns with outpatient PT clinics, have already demonstrated what a real infection control program can do at scale. University Hospitals Sports Medicine, working with hand hygiene manufacturer GOJO, ran a three-phase Infection Risk Reduction Program across two high school and two collegiate athletic training rooms over the 2017 to 2018 academic year. MRSA and vancomycin-resistant enterococcus (VRE), found on 24 percent of surfaces at baseline, were reduced to 0 percent by the end of the study, and overall bacterial load dropped by roughly 95 percent. No athletic training room-acquired infections were reported during the study period. (PMC, Sports Health 2020)

On the regulatory side, OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030) applies to any employer, including outpatient PT, chiro, and sports medicine practices, with employees who have reasonably anticipated occupational exposure to blood or other potentially infectious materials, which is common in wound care, manual therapy involving broken skin, or post-surgical rehab. (OSHA 1910.1030) The standard's most frequently cited provisions from 2013 through 2025 involve a missing or outdated written Exposure Control Plan, inadequate employee training, and failure to make Hepatitis B vaccination available, exactly the kind of paperwork and protocol gaps that turn a routine inspection into a citation. (OSHA Bloodborne Pathogens Enforcement) As of January 2025, OSHA's maximum penalties sit at $16,550 per serious or other-than-serious violation and $165,514 per willful or repeat violation, figures that carried into 2026 without a further increase. (DOL/OSHA 2025 penalty announcement) APTA, for its part, directs member clinics to CDC's Guideline for Disinfection and Sterilization in Healthcare Facilities as the operative infection control reference for equipment disinfection between patients. (APTA Infectious Disease Control)

What Should Get Disinfected Between Every Patient

• Treatment tables and plinths. Direct, sustained skin contact from every patient, and the surface every published chiropractic and PT contamination study has flagged first. (PMC chiropractic table study)
• Resistance bands and tubing handles. Passed hand to hand between patients doing home exercise program instruction, rarely laundered mid-day, and hard to visually inspect for soil.
• Exercise balls and stability balls. Broad skin and clothing contact area, frequently used barefoot or with exposed limbs during balance and core work.
• Foam rollers. Porous surface material, which the PLOS ONE rehab clinic study specifically linked to higher bacterial DNA recovery than non-porous surfaces. (PLOS ONE, 2023)
• Hand weights, dumbbells, and pulley handles. High grip contact, shared across a full day of appointments, rarely wiped between every single use in a busy clinic flow.
• Recumbent and upright bike seats and handlebars. Identified as the single highest-contamination site in the PLOS ONE rehabilitation clinic study. (PLOS ONE, 2023)
• Reusable hot and cold pack covers. Direct skin contact, often against compromised or post-surgical tissue, and fabric covers hold moisture and soil that plain wiping does not remove.
• BAPS boards, goniometers, and other hands-on assessment tools. Small, frequently handled items that move directly between the clinician's hands and the patient's skin.

Where UVCeed Fits

None of the studies above suggest that a clinic needs to overhaul its entire cleaning program. They point to a narrower, very practical gap: the hard, non-porous equipment and surfaces that get touched by one patient after another, often faster than a full wipe-and-dwell-time chemical cycle can realistically happen between every single appointment. That is the specific niche a handheld 254 nm UV-C device is built for. For a treatment table rail, a set of dumbbells, a pulley handle, or a recumbent bike's handlebars between patients, the workflow is simple: aim the device, hold steady until the app confirms the section is complete, then move to the next section. It adds a fast, trackable disinfection step for hard, line-of-sight surfaces without requiring a chemical dwell time on equipment that is about to be touched again in minutes.

UV-C should be treated as supplemental, not a replacement for your clinic's required chemical disinfection protocol, your Exposure Control Plan under OSHA's Bloodborne Pathogens Standard, or any sterilization process your state board or APTA/CDC guidance requires for specific tools. It is an added layer for the equipment that turns over constantly and is hardest to keep pace with using wipes alone. You can review the device and its specifications on the UVCeed product page.

What UV-C Does Not Do: An Honest Limitations Note

A handheld 254 nm UV-C device has real, specific limits, and being upfront about them matters more in a clinical setting than almost anywhere else in this content series. It is line of sight only: UV-C cannot disinfect a surface it cannot directly illuminate, so shadowed areas under a table base, the underside of a resistance band handle, or the inside seam of a fabric hot pack cover will not be reached. It does not penetrate porous materials or organic soil, which is a real constraint here specifically because the PLOS ONE study found porous surfaces carrying more bacterial contamination than hard ones, yet those same porous items, foam rollers, fabric pack covers, are the ones UV-C is least effective against. It does not address airborne transmission at all. It is not a sterilizer and cannot substitute for autoclaving or chemical sterilization of any instrument or tool that requires it under your state licensing board's rules. And it does not replace the written Exposure Control Plan, employee bloodborne pathogen training, or the CDC-referenced disinfection protocol that OSHA and APTA expect a clinic to already have in place. UV-C is a supplemental tool for hard, visible, reachable surfaces between patients, not a stand-in for your infection control program.

Frequently Asked Questions

Does OSHA's Bloodborne Pathogens Standard apply to a small physical therapy or chiropractic practice? Yes, if any employee has reasonably anticipated occupational exposure to blood or other potentially infectious materials, which commonly applies in wound care, manual therapy on broken skin, or post-surgical rehabilitation, regardless of clinic size. (29 CFR 1910.1030)

Is MRSA actually a realistic risk on PT and chiro equipment, or is that overstated? Published research has confirmed MRSA on chiropractic treatment tables in a peer-reviewed study, and athletic training rooms, which use similar shared equipment, measured MRSA and VRE on 24 percent of surfaces before a targeted infection control program brought that to zero. (PMC chiropractic study) (PMC athletic training room study)

Can UV-C replace wiping down the treatment table between patients? No. Chemical disinfection remains the required, documented step under APTA and CDC guidance, and UV-C should be used as an additional layer on hard equipment surfaces, not a substitute for that protocol. (APTA Infectious Disease Control)

Does frequency of patient contact predict how contaminated a surface is? Not as strongly as you might expect. The PLOS ONE rehabilitation clinic study found no significant correlation between contact frequency and contamination level, while surface material (porous versus non-porous) was a much stronger predictor. (PLOS ONE, 2023)

Bottom Line for Clinic Owners

The research picture for PT, chiropractic, and sports medicine clinics is consistent across three separate peer-reviewed studies published between 2023 and 2025: shared equipment, from treatment tables to recumbent bikes to resistance bands, carries measurable bacterial contamination, including MRSA in at least one confirmed case, and the surfaces that need the most attention are not always the ones touched most often. Chemical disinfection and a documented Exposure Control Plan remain the non-negotiable foundation, required by OSHA and referenced by APTA and CDC guidance. On top of that foundation, a handheld 254 nm UV-C device is a genuinely useful, fast supplemental step for the hard, non-porous, high-turnover equipment that is hardest to keep pace with between back-to-back patients. Learn more about the device on the UVCeed product page.