WHAT HAPPENS DURING MY FIRST VISIT?
Arrive at your appointment 10-15 minutes early to complete paperwork. You may download these from our website by clicking the “forms tab” for your medical history information.
We will copy your insurance card and driver’s license. You will then be seen by one of our licensed physical therapists for a 45 minute assessment.
Your therapist will:
Discuss your medical history, reason for referral, pain intensity, what aggravates and eases the condition, and any medication and testing you have had.
Also how your issues have affected daily life and activities. We will also discuss your goals and what activity level you would like to return to.
As part of our holistic assessment we may use the following techniques to determine the cause of your problems:
Palpation – 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, myofascial restriction, etc.
Range of Motion (ROM) – the therapist will move the joint(s) or ask you to move your joint (s) or parts of your spine to check for the quality of movement and any restrictions.
Muscle Testing – the therapist may check 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, spine, head and pelvis relative to ideal and each other may be assessed.
What Do I Need To Bring With Me?
Please being your physical therapy prescription from your doctor if we do not have it already. Bring your insurance card and a photo ID.
Any referrals for workers’ comp claims will require additional verification. In addition, please bring any imaging or special test results related to your condition if available.
How Should I Dress?
How Long Should I Plan To Be There?
WHAT ARE YOUR HOURS OF OPERATION?
Physical therapy patients are scheduled from 8-5 Monday-Friday, (last appointment at 4:30pm).
Massage therapy appointments are from 8-5 Monday-Friday and by appointment on Saturday 8am – 12pm with advanced notice.
How Many Visits Will I Need?
Sometimes insurance limits how many visits you are allowed to have in a calendar year. We are aware of this and will work with you to make sure we get the most of your visits.
Who Pays For The Treatment?
Can I Go Directly To A Physical Therapist?
What Do Physical Therapists Do?
The ability to maintain an upright posture and to move your arms and legs to perform all sorts of tasks and activities is an important component of your health. Most of us can learn to live with the various medical conditions that we may develop, but only if we are able to continue at our jobs, take care of our families, and enjoy important occasions with family and friends. All of these activities require the ability to move without difficulty or pain.
Because physical therapists are experts in movement and function, they do not confine their talents to treating people who are ill. A large part of a physical therapist’s program is directed at preventing injury, loss of movement, and even surgery. Physical therapists work as consultants in industrial settings to improve the design of the workplace and reduce the risk of workers overusing certain muscles or developing low back pain. They also provide services to athletes at all levels to screen for potential problems and institute preventive exercise programs. With the boom in the golf and fitness industries, a number of physical therapists are engaged in consulting with recreational golfers and fitness clubs to develop workouts that are safe and effective, especially for people who already know that they have a problem with their joints or their backs.
The cornerstones of physical therapy treatment are therapeutic exercise and functional training. In addition to “hands-on” care, physical therapists also educate patients to take care of themselves and to perform certain exercises on their own. Depending on the particular needs of a patient, physical therapists may also “mobilize” a joint (that is, perform certain types of movements at the end of your range of motion) or massage a muscle to promote proper movement and function. Physical therapists also use methods such as ultrasound (which uses high frequency waves to produce heat), hot packs, and ice. Although other kinds of practitioners will offer some of these treatments as “physical therapy,” it’s important for you to know that physical therapy can only be provided by qualified physical therapists or by physical therapist assistants, who 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 your insurance, but the coverage will vary with each plan. Most states do not legally require patients to see their physicians before seeing a physical therapist. Most of the time all you have to do is ask your doctor if physical therapy is right for you.
Why Should I Choose A Physical Therapist?
Why Choose A Private Practice Physical Therapist?
WHO WILL SEE ME FOR MY PHYSICAL THERAPY TREATMENT?
IS PHYSICAL THERAPY PAINFUL?
WHAT IS MYOFASCIAL RELEASE?
Trauma, inflammatory responses, and/or surgical procedures create myofascial restrictions that can produce tensile pressures of approximately 2,000 pounds per square inch on pain sensitive structures that do not show up in many of the standard tests (x-rays, myelograms, CAT scans, electromyography, etc.)
Myofascial release is a safe and very effective hands-on technique that involves applying gentle sustained pressure into the myofascial connective tissue restrictions to eliminate pain and restore motion. This essential “time element” has to do with the viscous flow and the piezoelectric phenomenon: a low load (gentle pressure) applied slowly will allow a viscoelastic medium (fascia) to elongate. Myofascial release treatment is performed directly on skin without oils, creams or machinery. This enables the therapist to accurately detect fascial restrictions and apply the appropriate amount of sustained pressure to facilitate release of the fascia
The medical approach is to drug patients so they temporarily are free from pain, but does nothing about the “straight-jacket” of pressure that is causing the pain. Traditional physical, occupational and massage therapy treats the symptoms caused by the pressure of the “straightjacket” of the Myofascial system, but does nothing about the “straightjacket” of pressure that causes and perpetuates the symptoms. This is why so many patients only have temporary results never seeming to get better with traditional therapy. Only Myofascial Release treats the entire Myofascial mind/body complex eliminating the pressure of the restricted Myofascial system (the straightjacket) that causes the symptoms.
WHAT KINDS OF TREATMENT WILL I RECEIVE?
Myofascial Release – as described at length in the above question
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 soft tissue kneading/massaging 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.
Joint Mobilization – hands-on therapeutic procedures intended to increase joint mobility. Mobilization is usually performed to increase mobility, delaying progressive stiffness, and to relieve pain. Most of our mobilizations are Maitland and Mulligan based.
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 people 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. We also utilize a cross-fit style exercise program for more advanced patients.
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.
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 as a home unit.
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.