 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
Frequently Asked Questions (FAQ)
What happens during my first visit?
During your first visit you can expect the following:
Patient paperwork must be completed prior to treatment. Many
patients find it preferable to download the Patient Forms from our
website (please see the Patient Forms link on the list of navigation
buttons on the left side of this page). Please arrive at least 5
minutes early even if you have completed your paperwork so that
we may review it with you prior to your appointment.
If you do not have time to fill out paperwork in advance, please
arrive at least 20 minutes prior to your appointment time. This will
allow plenty of time for you to complete all the forms and more
easily guarantee that you can start your appointment on time.
You will receive a prescription from your doctor for treatment. You
must bring your prescription or a copy with you to your first visit.
You may also have your physician fax a copy to our office prior to
your first visit.
• You will be seen for the initial evaluation by one of our
therapists.
• The therapist will discuss the following:
• The therapist will then perform the objective evaluation. This
may include some of the following procedures and testing.
and discuss potential causes and treatment options.
• Incorporating information provided by the patient, the
therapist will develop a treatment plan. This includes how many
times you should see the therapist per week, how many weeks you
will need therapy, home programs, patient education, short-
term/long-term goals, and what is expected after discharge from
therapy. This plan is created from input from you, your therapist,
and your doctor.
What do I need to bring with me?
Make sure you bring your physical therapy prescription (provided
to you by your doctor) and your payment information. If your
insurance is covering the cost of physical therapy, bring your
insurance card. If you are covered by Workers' Compensation,
bring your claim number and your case manager's contact
information. If you are being covered by auto insurance or an
attorney lien, make sure you bring this information.
How should I dress?
It is best to wear loose fitting comfortable clothing. This will allow
you to more easily expose the area that will be evaluated and
treated. We do have gowns and shorts available for anyone that
would like to use them during therapy. For knee problems, it is
best to wear shorts. If you are being seen for a shoulder problem,
a tank top would be good choice. When being treated for low back
problems, wear loose fitting shirt and pants or change into one of
our gowns to allow for a more comfortable and thorough
examination.
How long will each treatment last?
A treatment session will typically last 1 hour to 1 hour and 15
minutes.
How many visits will I need?
The number of visits will be different for each individual patient.
The length of care will depend upon your diagnosis, the severity of
your impairments, your past medical history, etc. Patients are re-
evaluated on a monthly basis. Therapists will send progress notes
to your doctor as well as their recommendations so that you can
discuss them with your physician and thus everyone will be
completely informed regarding your care.
Why is physical therapy a good choice?
Physical therapists are experts at treating movement and neuro-
musculoskeletal disorders. Pain often accompanies a movement
disorder and physical therapists can help correct the disorder and
relieve the pain. Whether the episode is from a recent injury or
from a chronic condition, a Stanford study revealed that more than
half of all Americans are suffering from pain.
Many people are aware that physical therapists are well equipped
to treat their pain but do not understand that they are experts at
identifying and treating the source of their pain. The distinction is
significant when you consider the possibility of eliminating the
underlying cause and living a pain free life. Physical therapy
combined with physical rehabilitation and wellness programs are
about restoring the quality of life that you once enjoyed prior to the
injury or trauma and maintaining that functional state of fitness.
What do physical therapists do?
The cornerstones of physical therapy treatment are therapeutic
exercise and functional training. In addition to hands-on care, a
physical therapist will also educate patients on the best methods of
taking care of themselves. This will often begin with how to perform
certain exercises on their own correctly as well as showing them
the most appropriate way to get of bed or the position that will
provide them with the most pain free sleeping. Depending on the
particular needs of the patient, the therapists may also mobilize a
joint (performing certain types of movements at the end of your
range of motion) or massage a muscle to promote proper
movement and function. Physical therapists use methods such as
ultrasound, hot packs, and ice compresses in order to reduce
inflammation and pain during the treatment process. Other types
of practitioners, will offer these treatments as "physical therapy,"
but it is important to know that physical therapy can only be
provided by qualified physical therapists or by physical therapist
assistants. (Physical Therapist assistants must complete a 2-year
education program and who work only under the direction and
supervision of physical therapists.)
Most forms of physical therapy treatment are covered by
insurance, but coverage will vary with each plan. Most states do
not legally require patients to see their physicians before seeing a
physical therapist. California state law however, does require you
to have a prescription from your physician prior to treatment by a
physical therapist. Just simply ask your doctor if physical therapy is
right for you.
Why are people referred to physical therapy?
Patients may be referred to physical therapy because of a
movement dysfunction associated with pain. Difficulty with moving
such as bending at the low back or difficulty sleeping on your
shoulder, will impact your daily activities. (i.e. problems lifting
yourself out of a chair, an inability to play the sports you love, or
trouble with walking, etc.). Physical therapists treat these
movement dysfunctions and their associated pains in order to
restore your body's ability to move in a normal manner.
Why should I choose a private practice physical therapist?
Who is better to see, a PT that works for a physician or a PT
that owns a private practice?
We leave it up to you to draw your own conclusions but here are
some facts. The studies indicate there were more treatments
(visits per patient were 39% to 45% higher in physician owned
clinics) and the cost was greater for those patients that attended a
physician owned physical therapy practice (both gross and net
revenue per patient were 30% to 40% higher) (1).
Another study indicated that licensed and non-licensed therapy
providers spent less time with each patient in physician owned
clinics and physical therapy assistants were substituted for
physical therapists. (2)
Another older study concluded that "Therapists who had treated
patients through direct access were significantly more likely to
believe that direct access had benefited them professionally and
benefited their patients than were therapists who had not practiced
through direct access."(3)
We believe that we can provide you with the highest quality of care
available and do it in a cost-effective manner. You will work closely
with your physical therapist and in most instances, your case will
be managed by the same physical therapist from the beginning to
the end of your experience with us.
1. Mitchell, J., Scott, E., "Physician Ownership of Physical
Therapy Services: Effects on Charges, Utilization, Profits, and
Service Characteristics", Journal of the American Medical
Association, 1992.
2. "Joint Ventures Among Health Care Providers in Florida,"
State of Florida Health Care Cost Containment Board, 1991.
3. Domholdt E, Durchholz AG. "Direct access use by
experienced therapists in states with direct access." Physical
Therapy 1992 Aug;72(8):569-74.
Who pays for the treatment?
Generally and in most cases, health insurance will cover the cost
of your treatment. You may review a summary on our insurance
link above for a partial list of the insurances we accept. Please be
sure to speak with our receptionist so we can help you clarify your
insurance coverage. We will be happy to answer any questions
that you might have regarding your coverage or contact your
insurance company to verify information.
Who will see me?
You will be evaluated by one of our licensed and highly trained
physical therapists as well as seeing them for your subsequent
visits. In many clinics, you may see someone different each visit.
At PhysioFit, we believe that it is very important to develop a one-
on-one relationship with your therapist to maintain a continuity of
care. This will allow the therapist to work more closely with you to
speed your recovery.
Are there physical therapy specialists?
Orthopedic Physical Therapy: This is the most common
physical therapy specialist. These specialists care for post-surgical
patients, arthritis, tendinitis/tendinosus, fracture rehabilitation,
muscle sprains and strains, neck and back pain, hip and knee
problems, shoulder, elbow, and wrist conditions. Some are board
certified as Orthopedic Certified Specialists (OCS).
Manual Therapy: Manual therapy is a term that describes a
variety of hands-on treatment techniques that are used to treat
movement dysfunctions. Many manual therapists will take
continuing education courses, obtain certifications in manual
therapy, and will sit for board certification. Many physical
therapists will incorporate manual therapy techniques as a part of
their treatment plan.
Sports Rehabilitation: Many sports specialists help with
retraining the athlete utilizing running, throwing, jumping, and sport-
specific programs to name a few. A therapist with the SCS (Sports
Certified Specialist) title has passed a board certified test.
Fitness and Wellness: Physical therapists are well trained to
assist you in the development of an appropriate fitness or wellness
program. If you are concerned about osteoporosis, diabetes, or
would like to learn about fall prevention strategies, our physical
therapists can help. We offer many programs from Yoga and
Pilates group classes and private sessions to Personal Training
and post-therapy exercise maintenance programs. Please feel free
to ask one of our staff regarding all of the available options.
Hand Therapy: Physical therapists are trained to treat hand and
wrist conditions that are so prevalent in the information age.
Spending so many hours at our desks and using computers at
work and at home are common causes of repetitive injury. Often,
therapists will continue their education by attending additional
courses and training. As with other specialized areas, the
therapists are likely to have acquired a hand therapy certification.
These therapists are referred to as Certified Hand Therapists or
CHTs.
Women's Health - some therapists specialize in women's issues
such as pregnancy problems, pelvic pain, and incontinence.
Special treatment is available for women that have these
problems. Many that suffer from incontinence do so needlessly. A
physical therapist may be able to help.
Pediatric Physical Therapy - pediatric therapists specialize in the
rehabilitation of children. They may assist with kids that suffer from
cerebral palsy, developmental disorders, neurological disorders,
and/or orthopedic problems. A Pediatric Certified Specialist (PCS)
is a board certification that some may obtain from the American
Physical Therapy Association.
Cardiac and Pulmonary Rehabilitation - a small percentage of
physical therapists practice in this discipline. Those that pass the
board certification have the title of CCS (Cardiovascular and
Pulmonary Certified Specialist) work with patients that have had
heart attacks, bypass surgeries, angioplasty, breathing problems,
emphysema, and other heart/lung related conditions. Physical
therapists are well equipped to work with these types of patients
because many of them have orthopedic ailments that limit their
ability to function. In other words, a physical therapist can address
the heart and lung problems as well as the muscle problems that
are concurrently present.
Balance, Dizziness, and Vertigo Rehabilitation - many suffer from
dizziness or BPPV (benign paroxysmal positional vertigo). Some
clinics specialize in the rehabilitation of patients with vertigo.
Patient education, strengthening, safety awareness, posture and
balance exercise, walking exercise, and special techniques that
affect sensory and balance centers of the brain and limbs are all
important components of a rehabilitation program.
Amputee Rehabilitation - many physical therapists specialize in the
rehabilitation of amputees. Caring for the injured limb, functional
and walking training, training in the use of assistive devices
(crutches, canes, prosthetic limbs, etc.) are all provided by a
therapist that specializes in care for amputees.
Is physical therapy painful?
For many patients, one of the primary objectives is pain relief. This
is frequently accomplished with hands-on techniques, modalities
such as ultrasound, electrical stimulation, and/or heat or cold
therapy. Movement often provides pain relief as well. Your physical
therapist will provide you with the appropriate exercises not only
for pain relief but to recover range of motion, strength, and
endurance.
In some cases, physical therapy techniques can be painful. For
example, recovering knee range of motion after total knee
replacement or shoulder range of motion after shoulder surgery
may be painful. Your physical therapist will utilize a variety of
techniques to help maximize your treatment goals. It is important
that you communicate the intensity, frequency, and duration of
pain to your therapist. Without this information, it is difficult for the
therapist to adjust your treatment plan.
What types of treatments will I receive?
There are dozens of different types of treatment interventions.
Here is a list of treatment interventions:
Active Range of Motion (AROM) - the patient lifts or moves a
body part through range of motion against gravity. AROM is
usually one of the first modalities prescribed for arthritis.
Active Assistive Range of Motion (AAROM) - therapist-
assisted active range of motion. This is usually prescribed for
gentle stretching or strengthening for a very weak body part.
Stationary Bicycle - with or without resistance. This is usually
prescribed for improving the strength and/or range of motion of
the back or lower extremities as well as cardiovascular endurance.
Gait or Walking Training - the analysis of walking problems by
visually examining the interaction of the low back and the joints of
the thighs, legs, and feet during the various stages of walking,
including initial contact, loading response, mid stance, terminal
stance, pre swing, mid swing, and terminal swing. Many back,
thigh, leg, ankle, and foot problems may be caused by or manifest
themselves in subtle gait abnormalities.
Isometrics - muscle contraction without joint movement. This is
usually prescribed for strengthening without stressing or damaging
the joint (e.g., arthritis, or exercises to be performed in a cast, or
right after surgery if recommended by the therapist/doctor).
Isotonics - muscle(s) contracting through the ROM with
resistance. This is usually prescribed for strengthening.
Soft Tissue Mobilization - therapeutic massage of body tissue,
performed with the hands. Soft tissue mobilization may be used for
muscle relaxation, to decrease swelling, to decrease scar tissue
adhesions, and for pain relief.
Mobilization - hands-on therapeutic procedures intended to
increase soft tissue or joint mobility. Mobilization is usually
prescribed to increase mobility, delaying progressive stiffness, and
to relieve pain. There are many types of mobilization techniques
including Maitland, Kaltenborn, Isometric Mobilizations, etc.
Proprioceptive Neuromuscular Facilitation (PNF) - a system
of manually resisted exercises performed in diagonal patterns that
mimic functional movements. PNF was initially used in
developmentally and neurologically impaired patients but now is
used in almost every aspect of neuromuscular retraining from
athletes in sports facilities to the very weak in hospitals and
nursing homes.
Posture Training - instruction in the correct biomechanical
alignment of the body to reduce undue strain on muscles, joints,
ligaments, discs, and other soft tissues. There is an ideal posture
but most do not have ideal posture. Therapists educate patients
about the importance of improving posture with daily activities.
Stretching and strengthening exercises may be prescribed to
facilitate postural improvement and to prevent further disability and
future recurrences of problems.
Progressive Resistive Exercises (PRE) - exercises that
gradually increase in resistance (weights) and in repetitions. PRE
is usually prescribed for reeducation of muscles and
strengthening. Weights, rubber bands, and body weight can be
used as resistance.
Passive Range of Motion (PROM) - the patient or therapist moves
the body part through a range of motion without the use of the
muscles that "actively" move the joint(s).
Stretching/Flexibility Exercise - exercise designed to lengthen
muscle(s) or soft tissue. Stretching exercises are usually
prescribed to improve the flexibility of muscles that have tightened
due to disuse or in compensation to pain, spasm or immobilization.
Cryotherapy or Cold Therapy - used to cause vasoconstriction
(the blood vessels constrict or decrease their diameter) to reduce
the amount of fluid that leaks out of the capillaries into the tissue
spaces (swelling) in response to injury of tissue. Ice or cold is used
most frequently in acute injuries, but also an effective pain reliever
for even the most chronic pain.
Neuromuscular Electrical Stimulation (NMES) - the application
of electrical stimulation to aid in improving strength (e.g., the
quadriceps muscle after knee surgery or injury). NMES is also
used to decrease pain and swelling and to relieve muscle spasm.
Neck Traction - a gentle longitudinal/axial pull on the neck, either
manual or mechanical, intermittent or continuous for relief of neck
pain, to decrease muscle spasm, and facilitate unloading of the
spine.
Heat - heat is recommended to decrease chronic pain, relax
muscles, and for pain relief. It should not be used with an acute or
"new" injury.
Iontophoresis - medications are propelled through the skin by an
electrical charge. This modality works on the physical concept that
like charges repel each other, therefore, a positively charged
medication will be repelled through the skin to the underlying
tissues by the positively charged pad of an iontophoresis machine.
Iontophoresis is usually prescribed for injuries such as shoulder or
elbow bursitis.
Transcutaneous Electrical Nerve Stimulation (TENS) - a
relatively low voltage applied over painful areas through small self-
adhesive electrodes. The electrical stimulation "disguises" or
"overrides" the sensation of pain. It is a small, portable unit, used
in intervals, to control pain and reduce dependence on drugs. It is
usually prescribed for relief of pain.
Ultrasound - ultrasound uses a high frequency sound wave
emitted from the sound head when electricity is passed through a
quartz crystal. The sound waves cause the vibration of water
molecules deep within tissue causing a heating effect. When the
sound waves are pulsed, they cause a vibration of the tissue
rather than heating. The stream of sound waves helps with
nutrition exchange at the cellular level and healing. Studies have
shown that ultrasound is helpful for ligament healing and clinically,
for carpal tunnel syndrome, and muscle spasm.
Will I get a massage at physical therapy?
Massage may be part of your treatment. Rehabilitation specialists
are trained in a variety of techniques that may help with your
recovery. Deep tissue techniques may be part of the rehabilitative
process. Massage is used for three reasons typically - to facilitate
venous return from a swollen area, to relax a tight muscle, or to
relieve pain. Contrary to common thought, massage does not
increase circulation.
What happens if my problem or pain returns?
Experiencing a flare up is not uncommon. If you have a flare up
(exacerbation), give us a call. We may suggest you come back to
see us, return to your doctor, or simply modify your daily activities
or exercise routine.
Can I go to any physical therapy clinic?
In most cases, you have the right to choose any physical therapy
clinic. Our clinic takes many different insurance plans; we can
discuss your options through a quick phone call with our office
manager. Our clinic may not be a provider for your insurance plan.
You can still come to our clinic, but it is likely that you will have to
pay out-of-pocket for the treatments.
The best thing to do is give us a call and we will attempt to answer
all of your questions.
Can I go directly to my physical therapist?
Forty-three states have some form of direct access. Some state
physical therapy practice acts require a diagnosis before a patient
can see a therapist (this is the case in California, Michigan, and
Colorado to name a few). Other states allow patients to go directly
to physical therapists. In most cases, if you are not making
significant improvement within 30 days, the therapist will refer you
to/back to your physician.
Direct Access Reference
Can my therapist provide me with a diagnosis?
In most states, physical therapists cannot make a medical
diagnosis. This is something that your medical doctor will provide
for you.
Physical therapists are important members of your medical team.
At this point in time, physicians are typically the health care
providers that will provide you with a medical diagnosis.
How does the billing process work?
Billing for physical therapy services is similar to what happens at
your doctor's office. When you are seen for treatment the following
occurs:
It is important to understand that there are many small steps
(beyond the outline provided above) within the process.
Exceptions are common to the above example as well. At any time
along the way, information may be missing, mis-communicated, or
misunderstood. This can delay the payment process. While it is
common for the payment process to be completed in 60 days or
less, it is not uncommon for the physical therapy clinic to receive
payment as long as 6 months after the treatment date.
What will I have to do after physical therapy?
Some patients will need to continue with home exercises. Other
patients will have completed their rehabilitation and can return to
normal daily activities. Others may wish to continue with a gym
exercise program. It is important that you communicate with your
therapist so he/she can assist you in creating long-term goals for
you.
Is my therapist licensed?
Physical therapists (PT's) and physical therapist assistants (PTA's)
are licensed by their respective states.
How do I choose a physical therapy clinic?
Since sitting and driving often aggravate orthopedic problems,
there should be a very good reason for you to drive a long
distance for rehabilitation.
What happens during my first visit?
During your first visit you can expect the following:
Patient paperwork must be completed prior to treatment. Many
patients find it preferable to download the Patient Forms from our
website (please see the Patient Forms link on the list of navigation
buttons on the left side of this page). Please arrive at least 5
minutes early even if you have completed your paperwork so that
we may review it with you prior to your appointment.
If you do not have time to fill out paperwork in advance, please
arrive at least 20 minutes prior to your appointment time. This will
allow plenty of time for you to complete all the forms and more
easily guarantee that you can start your appointment on time.
You will receive a prescription from your doctor for treatment. You
must bring your prescription or a copy with you to your first visit.
You may also have your physician fax a copy to our office prior to
your first visit.
• You will be seen for the initial evaluation by one of our
therapists.
• The therapist will discuss the following:
- your medical history
- your current problems/complaints
- pain intensity, what aggravates and eases the problem
- how this is impacting your daily activities
- functional limitations
- your goals with physical therapy
- medications, tests, and procedures related to your health
• The therapist will then perform the objective evaluation. This
may include some of the following procedures and testing.
- Palpation or touching around the area of the pain/problem.
This is done to check for the presence of tenderness,
swelling, soft tissue integrity, tissue temperature,
inflammation, etc.
Range of Motion (ROM) - the therapist will move the joint(s)
to check for the quality of movement and any restrictions.
Testing muscle strength - the therapist is checking for
strength and the quality of the muscle contraction. Pain and
weakness may be noted. Often the muscle strength is
graded. This is also part of a neurological screening.
Neurological Screening - the therapist may check to see
how the nerves are communicating with the muscles,
sensing touch, pain, vibration, or temperature. Reflexes may
be assessed as well.
Special tests - the therapist may perform special tests to
confirm/rule out the presence of additional problems.
Posture assessment - the positions of joints relative to ideal
and each other may be assessed.
and discuss potential causes and treatment options.
• Incorporating information provided by the patient, the
therapist will develop a treatment plan. This includes how many
times you should see the therapist per week, how many weeks you
will need therapy, home programs, patient education, short-
term/long-term goals, and what is expected after discharge from
therapy. This plan is created from input from you, your therapist,
and your doctor.
What do I need to bring with me?
Make sure you bring your physical therapy prescription (provided
to you by your doctor) and your payment information. If your
insurance is covering the cost of physical therapy, bring your
insurance card. If you are covered by Workers' Compensation,
bring your claim number and your case manager's contact
information. If you are being covered by auto insurance or an
attorney lien, make sure you bring this information.
How should I dress?
It is best to wear loose fitting comfortable clothing. This will allow
you to more easily expose the area that will be evaluated and
treated. We do have gowns and shorts available for anyone that
would like to use them during therapy. For knee problems, it is
best to wear shorts. If you are being seen for a shoulder problem,
a tank top would be good choice. When being treated for low back
problems, wear loose fitting shirt and pants or change into one of
our gowns to allow for a more comfortable and thorough
examination.
How long will each treatment last?
A treatment session will typically last 1 hour to 1 hour and 15
minutes.
How many visits will I need?
The number of visits will be different for each individual patient.
The length of care will depend upon your diagnosis, the severity of
your impairments, your past medical history, etc. Patients are re-
evaluated on a monthly basis. Therapists will send progress notes
to your doctor as well as their recommendations so that you can
discuss them with your physician and thus everyone will be
completely informed regarding your care.
Why is physical therapy a good choice?
Physical therapists are experts at treating movement and neuro-
musculoskeletal disorders. Pain often accompanies a movement
disorder and physical therapists can help correct the disorder and
relieve the pain. Whether the episode is from a recent injury or
from a chronic condition, a Stanford study revealed that more than
half of all Americans are suffering from pain.
Many people are aware that physical therapists are well equipped
to treat their pain but do not understand that they are experts at
identifying and treating the source of their pain. The distinction is
significant when you consider the possibility of eliminating the
underlying cause and living a pain free life. Physical therapy
combined with physical rehabilitation and wellness programs are
about restoring the quality of life that you once enjoyed prior to the
injury or trauma and maintaining that functional state of fitness.
What do physical therapists do?
The cornerstones of physical therapy treatment are therapeutic
exercise and functional training. In addition to hands-on care, a
physical therapist will also educate patients on the best methods of
taking care of themselves. This will often begin with how to perform
certain exercises on their own correctly as well as showing them
the most appropriate way to get of bed or the position that will
provide them with the most pain free sleeping. Depending on the
particular needs of the patient, the therapists may also mobilize a
joint (performing certain types of movements at the end of your
range of motion) or massage a muscle to promote proper
movement and function. Physical therapists use methods such as
ultrasound, hot packs, and ice compresses in order to reduce
inflammation and pain during the treatment process. Other types
of practitioners, will offer these treatments as "physical therapy,"
but it is important to know that physical therapy can only be
provided by qualified physical therapists or by physical therapist
assistants. (Physical Therapist assistants must complete a 2-year
education program and who work only under the direction and
supervision of physical therapists.)
Most forms of physical therapy treatment are covered by
insurance, but coverage will vary with each plan. Most states do
not legally require patients to see their physicians before seeing a
physical therapist. California state law however, does require you
to have a prescription from your physician prior to treatment by a
physical therapist. Just simply ask your doctor if physical therapy is
right for you.
Why are people referred to physical therapy?
Patients may be referred to physical therapy because of a
movement dysfunction associated with pain. Difficulty with moving
such as bending at the low back or difficulty sleeping on your
shoulder, will impact your daily activities. (i.e. problems lifting
yourself out of a chair, an inability to play the sports you love, or
trouble with walking, etc.). Physical therapists treat these
movement dysfunctions and their associated pains in order to
restore your body's ability to move in a normal manner.
Why should I choose a private practice physical therapist?
Who is better to see, a PT that works for a physician or a PT
that owns a private practice?
We leave it up to you to draw your own conclusions but here are
some facts. The studies indicate there were more treatments
(visits per patient were 39% to 45% higher in physician owned
clinics) and the cost was greater for those patients that attended a
physician owned physical therapy practice (both gross and net
revenue per patient were 30% to 40% higher) (1).
Another study indicated that licensed and non-licensed therapy
providers spent less time with each patient in physician owned
clinics and physical therapy assistants were substituted for
physical therapists. (2)
Another older study concluded that "Therapists who had treated
patients through direct access were significantly more likely to
believe that direct access had benefited them professionally and
benefited their patients than were therapists who had not practiced
through direct access."(3)
We believe that we can provide you with the highest quality of care
available and do it in a cost-effective manner. You will work closely
with your physical therapist and in most instances, your case will
be managed by the same physical therapist from the beginning to
the end of your experience with us.
1. Mitchell, J., Scott, E., "Physician Ownership of Physical
Therapy Services: Effects on Charges, Utilization, Profits, and
Service Characteristics", Journal of the American Medical
Association, 1992.
2. "Joint Ventures Among Health Care Providers in Florida,"
State of Florida Health Care Cost Containment Board, 1991.
3. Domholdt E, Durchholz AG. "Direct access use by
experienced therapists in states with direct access." Physical
Therapy 1992 Aug;72(8):569-74.
Who pays for the treatment?
Generally and in most cases, health insurance will cover the cost
of your treatment. You may review a summary on our insurance
link above for a partial list of the insurances we accept. Please be
sure to speak with our receptionist so we can help you clarify your
insurance coverage. We will be happy to answer any questions
that you might have regarding your coverage or contact your
insurance company to verify information.
Who will see me?
You will be evaluated by one of our licensed and highly trained
physical therapists as well as seeing them for your subsequent
visits. In many clinics, you may see someone different each visit.
At PhysioFit, we believe that it is very important to develop a one-
on-one relationship with your therapist to maintain a continuity of
care. This will allow the therapist to work more closely with you to
speed your recovery.
Are there physical therapy specialists?
Orthopedic Physical Therapy: This is the most common
physical therapy specialist. These specialists care for post-surgical
patients, arthritis, tendinitis/tendinosus, fracture rehabilitation,
muscle sprains and strains, neck and back pain, hip and knee
problems, shoulder, elbow, and wrist conditions. Some are board
certified as Orthopedic Certified Specialists (OCS).
Manual Therapy: Manual therapy is a term that describes a
variety of hands-on treatment techniques that are used to treat
movement dysfunctions. Many manual therapists will take
continuing education courses, obtain certifications in manual
therapy, and will sit for board certification. Many physical
therapists will incorporate manual therapy techniques as a part of
their treatment plan.
Sports Rehabilitation: Many sports specialists help with
retraining the athlete utilizing running, throwing, jumping, and sport-
specific programs to name a few. A therapist with the SCS (Sports
Certified Specialist) title has passed a board certified test.
Fitness and Wellness: Physical therapists are well trained to
assist you in the development of an appropriate fitness or wellness
program. If you are concerned about osteoporosis, diabetes, or
would like to learn about fall prevention strategies, our physical
therapists can help. We offer many programs from Yoga and
Pilates group classes and private sessions to Personal Training
and post-therapy exercise maintenance programs. Please feel free
to ask one of our staff regarding all of the available options.
Hand Therapy: Physical therapists are trained to treat hand and
wrist conditions that are so prevalent in the information age.
Spending so many hours at our desks and using computers at
work and at home are common causes of repetitive injury. Often,
therapists will continue their education by attending additional
courses and training. As with other specialized areas, the
therapists are likely to have acquired a hand therapy certification.
These therapists are referred to as Certified Hand Therapists or
CHTs.
Women's Health - some therapists specialize in women's issues
such as pregnancy problems, pelvic pain, and incontinence.
Special treatment is available for women that have these
problems. Many that suffer from incontinence do so needlessly. A
physical therapist may be able to help.
Pediatric Physical Therapy - pediatric therapists specialize in the
rehabilitation of children. They may assist with kids that suffer from
cerebral palsy, developmental disorders, neurological disorders,
and/or orthopedic problems. A Pediatric Certified Specialist (PCS)
is a board certification that some may obtain from the American
Physical Therapy Association.
Cardiac and Pulmonary Rehabilitation - a small percentage of
physical therapists practice in this discipline. Those that pass the
board certification have the title of CCS (Cardiovascular and
Pulmonary Certified Specialist) work with patients that have had
heart attacks, bypass surgeries, angioplasty, breathing problems,
emphysema, and other heart/lung related conditions. Physical
therapists are well equipped to work with these types of patients
because many of them have orthopedic ailments that limit their
ability to function. In other words, a physical therapist can address
the heart and lung problems as well as the muscle problems that
are concurrently present.
Balance, Dizziness, and Vertigo Rehabilitation - many suffer from
dizziness or BPPV (benign paroxysmal positional vertigo). Some
clinics specialize in the rehabilitation of patients with vertigo.
Patient education, strengthening, safety awareness, posture and
balance exercise, walking exercise, and special techniques that
affect sensory and balance centers of the brain and limbs are all
important components of a rehabilitation program.
Amputee Rehabilitation - many physical therapists specialize in the
rehabilitation of amputees. Caring for the injured limb, functional
and walking training, training in the use of assistive devices
(crutches, canes, prosthetic limbs, etc.) are all provided by a
therapist that specializes in care for amputees.
Is physical therapy painful?
For many patients, one of the primary objectives is pain relief. This
is frequently accomplished with hands-on techniques, modalities
such as ultrasound, electrical stimulation, and/or heat or cold
therapy. Movement often provides pain relief as well. Your physical
therapist will provide you with the appropriate exercises not only
for pain relief but to recover range of motion, strength, and
endurance.
In some cases, physical therapy techniques can be painful. For
example, recovering knee range of motion after total knee
replacement or shoulder range of motion after shoulder surgery
may be painful. Your physical therapist will utilize a variety of
techniques to help maximize your treatment goals. It is important
that you communicate the intensity, frequency, and duration of
pain to your therapist. Without this information, it is difficult for the
therapist to adjust your treatment plan.
What types of treatments will I receive?
There are dozens of different types of treatment interventions.
Here is a list of treatment interventions:
Active Range of Motion (AROM) - the patient lifts or moves a
body part through range of motion against gravity. AROM is
usually one of the first modalities prescribed for arthritis.
Active Assistive Range of Motion (AAROM) - therapist-
assisted active range of motion. This is usually prescribed for
gentle stretching or strengthening for a very weak body part.
Stationary Bicycle - with or without resistance. This is usually
prescribed for improving the strength and/or range of motion of
the back or lower extremities as well as cardiovascular endurance.
Gait or Walking Training - the analysis of walking problems by
visually examining the interaction of the low back and the joints of
the thighs, legs, and feet during the various stages of walking,
including initial contact, loading response, mid stance, terminal
stance, pre swing, mid swing, and terminal swing. Many back,
thigh, leg, ankle, and foot problems may be caused by or manifest
themselves in subtle gait abnormalities.
Isometrics - muscle contraction without joint movement. This is
usually prescribed for strengthening without stressing or damaging
the joint (e.g., arthritis, or exercises to be performed in a cast, or
right after surgery if recommended by the therapist/doctor).
Isotonics - muscle(s) contracting through the ROM with
resistance. This is usually prescribed for strengthening.
Soft Tissue Mobilization - therapeutic massage of body tissue,
performed with the hands. Soft tissue mobilization may be used for
muscle relaxation, to decrease swelling, to decrease scar tissue
adhesions, and for pain relief.
Mobilization - hands-on therapeutic procedures intended to
increase soft tissue or joint mobility. Mobilization is usually
prescribed to increase mobility, delaying progressive stiffness, and
to relieve pain. There are many types of mobilization techniques
including Maitland, Kaltenborn, Isometric Mobilizations, etc.
Proprioceptive Neuromuscular Facilitation (PNF) - a system
of manually resisted exercises performed in diagonal patterns that
mimic functional movements. PNF was initially used in
developmentally and neurologically impaired patients but now is
used in almost every aspect of neuromuscular retraining from
athletes in sports facilities to the very weak in hospitals and
nursing homes.
Posture Training - instruction in the correct biomechanical
alignment of the body to reduce undue strain on muscles, joints,
ligaments, discs, and other soft tissues. There is an ideal posture
but most do not have ideal posture. Therapists educate patients
about the importance of improving posture with daily activities.
Stretching and strengthening exercises may be prescribed to
facilitate postural improvement and to prevent further disability and
future recurrences of problems.
Progressive Resistive Exercises (PRE) - exercises that
gradually increase in resistance (weights) and in repetitions. PRE
is usually prescribed for reeducation of muscles and
strengthening. Weights, rubber bands, and body weight can be
used as resistance.
Passive Range of Motion (PROM) - the patient or therapist moves
the body part through a range of motion without the use of the
muscles that "actively" move the joint(s).
Stretching/Flexibility Exercise - exercise designed to lengthen
muscle(s) or soft tissue. Stretching exercises are usually
prescribed to improve the flexibility of muscles that have tightened
due to disuse or in compensation to pain, spasm or immobilization.
Cryotherapy or Cold Therapy - used to cause vasoconstriction
(the blood vessels constrict or decrease their diameter) to reduce
the amount of fluid that leaks out of the capillaries into the tissue
spaces (swelling) in response to injury of tissue. Ice or cold is used
most frequently in acute injuries, but also an effective pain reliever
for even the most chronic pain.
Neuromuscular Electrical Stimulation (NMES) - the application
of electrical stimulation to aid in improving strength (e.g., the
quadriceps muscle after knee surgery or injury). NMES is also
used to decrease pain and swelling and to relieve muscle spasm.
Neck Traction - a gentle longitudinal/axial pull on the neck, either
manual or mechanical, intermittent or continuous for relief of neck
pain, to decrease muscle spasm, and facilitate unloading of the
spine.
Heat - heat is recommended to decrease chronic pain, relax
muscles, and for pain relief. It should not be used with an acute or
"new" injury.
Iontophoresis - medications are propelled through the skin by an
electrical charge. This modality works on the physical concept that
like charges repel each other, therefore, a positively charged
medication will be repelled through the skin to the underlying
tissues by the positively charged pad of an iontophoresis machine.
Iontophoresis is usually prescribed for injuries such as shoulder or
elbow bursitis.
Transcutaneous Electrical Nerve Stimulation (TENS) - a
relatively low voltage applied over painful areas through small self-
adhesive electrodes. The electrical stimulation "disguises" or
"overrides" the sensation of pain. It is a small, portable unit, used
in intervals, to control pain and reduce dependence on drugs. It is
usually prescribed for relief of pain.
Ultrasound - ultrasound uses a high frequency sound wave
emitted from the sound head when electricity is passed through a
quartz crystal. The sound waves cause the vibration of water
molecules deep within tissue causing a heating effect. When the
sound waves are pulsed, they cause a vibration of the tissue
rather than heating. The stream of sound waves helps with
nutrition exchange at the cellular level and healing. Studies have
shown that ultrasound is helpful for ligament healing and clinically,
for carpal tunnel syndrome, and muscle spasm.
Will I get a massage at physical therapy?
Massage may be part of your treatment. Rehabilitation specialists
are trained in a variety of techniques that may help with your
recovery. Deep tissue techniques may be part of the rehabilitative
process. Massage is used for three reasons typically - to facilitate
venous return from a swollen area, to relax a tight muscle, or to
relieve pain. Contrary to common thought, massage does not
increase circulation.
What happens if my problem or pain returns?
Experiencing a flare up is not uncommon. If you have a flare up
(exacerbation), give us a call. We may suggest you come back to
see us, return to your doctor, or simply modify your daily activities
or exercise routine.
Can I go to any physical therapy clinic?
In most cases, you have the right to choose any physical therapy
clinic. Our clinic takes many different insurance plans; we can
discuss your options through a quick phone call with our office
manager. Our clinic may not be a provider for your insurance plan.
You can still come to our clinic, but it is likely that you will have to
pay out-of-pocket for the treatments.
The best thing to do is give us a call and we will attempt to answer
all of your questions.
Can I go directly to my physical therapist?
Forty-three states have some form of direct access. Some state
physical therapy practice acts require a diagnosis before a patient
can see a therapist (this is the case in California, Michigan, and
Colorado to name a few). Other states allow patients to go directly
to physical therapists. In most cases, if you are not making
significant improvement within 30 days, the therapist will refer you
to/back to your physician.
Direct Access Reference
Can my therapist provide me with a diagnosis?
In most states, physical therapists cannot make a medical
diagnosis. This is something that your medical doctor will provide
for you.
Physical therapists are important members of your medical team.
At this point in time, physicians are typically the health care
providers that will provide you with a medical diagnosis.
How does the billing process work?
Billing for physical therapy services is similar to what happens at
your doctor's office. When you are seen for treatment the following
occurs:
- The physical therapist bills your insurance company,
Worker's Comp, or charges you based on CPT (Common
Procedure Terminology) codes. - Those codes are transferred to a billing form that is either
mailed or electronically communicated to the payer. - The payer processes this information and makes payments
according to an agreed upon fee schedule. - An EOB (Explanation of Benefits) is generated and sent to
the patient and the physical therapy clinic with a check for
payment and a balance due by the patient. - As the patient, you are expected to make the payment on
the final balance of the account.
It is important to understand that there are many small steps
(beyond the outline provided above) within the process.
Exceptions are common to the above example as well. At any time
along the way, information may be missing, mis-communicated, or
misunderstood. This can delay the payment process. While it is
common for the payment process to be completed in 60 days or
less, it is not uncommon for the physical therapy clinic to receive
payment as long as 6 months after the treatment date.
What will I have to do after physical therapy?
Some patients will need to continue with home exercises. Other
patients will have completed their rehabilitation and can return to
normal daily activities. Others may wish to continue with a gym
exercise program. It is important that you communicate with your
therapist so he/she can assist you in creating long-term goals for
you.
Is my therapist licensed?
Physical therapists (PT's) and physical therapist assistants (PTA's)
are licensed by their respective states.
How do I choose a physical therapy clinic?
- Do they have a service that can address your problem?
- Do they take your insurance?
- Are they willing to work with you if they are not a preferred
provider? - Are they conveniently located?
Since sitting and driving often aggravate orthopedic problems,
there should be a very good reason for you to drive a long
distance for rehabilitation.
- What are the hours of operation?
- Can they provide satisfaction survey results?
- The therapist should provide the treatment.
- Can you briefly interview the therapist before the first visit?
- Ask your family and friends who they would recommend.v
However, many do not even know that physical therapists
are well equipped to not only treat pain but also its source.
