1. What is a physical therapist?

Physical therapists are highly educated, licensed healthcare professionals who specialize in reducing pain and improving/restoring mobility. A physical therapist can teach patients how to prevent or manage their condition so that they will achieve long-term health benefits. PTs examine each individual and develop a plan, using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.

2. Do I need a referral?

If you have an HMO plan and typically need a referral to see a specialist (orthopedist, neurologist, etc.),then you would need an insurance referral for physical therapy. Some PPO plans allow you to come directly to physical therapy without obtaining a referral. In some cases, you would only need a prescription from a referring physician. If you are not familiar with your coverage and benefits, please contact your insurance plan. Our staff is also happy to assist you with any questions you may have regarding your coverage.

3. How soon can I receive an appointment?

We can usually accommodate same day appointments. Otherwise we will try to schedule you within 24-48 hours of your initial call to us.

4. Can I go to any physical therapy clinic?

Yes, you have the right to choose any physical therapy clinic. We are a network provider for most insurance plans. Please see our insurance page for a list of all plans accepted.

5. What should I bring with me to my first visit?

You will need to bring the physical therapy prescription provided by your doctor (if required by your health plan). If your visit will be covered by your health insurance, bring your insurance card. If your insurance plan is an HMO, you will also need to obtain an insurance referral from your Primary Care Physician’s office. If you were injured while working and have an accepted Workers Compensation claim, bring your claim number and your case manager’s contact information. If you were injured in an automobile accident, please bring any auto insurance and/or attorney information.

6. What should I wear?

You should plan to wear loose fitting clothing. If you have a knee injury, you should wear or bring shorts or sweatpants that can be raised above the knee. For shoulder and low back problems, wear or bring a loose fitting shirt and pants, so that a thorough examination may be performed. You should also wear proper footwear appropriate for exercise (not sandals).

7. How many visits will I need?

Many factors will determine whether you need one visit or months of treatment. It will depend on your diagnosis, your past medical history, your compliance with your home exercise program, etc. Patients are re-evaluated on a monthly basis and when you see your doctor, we will provide you with a progress report to bring to your appointment.

8. How long will each treatment last?

A typical physical therapy treatment session lasts 30 to 60 minutes per visit.

9. What will happen during my first visit?

You will be seen for the initial evaluation by the therapist who will discuss the following:
o Your medical history.
o Your current problems/complaints.
o Your pain intensity.
o How this is impacting your daily activities and/or your functional limitations.
o Your goals with physical therapy.
o Medications, tests, and procedures related to your health.

The therapist will then perform the objective evaluation which may include the following:
Palpation – touching around the area of the pain/injury. This is done to check for the presence of tenderness, swelling, inflammation, etc.
Range of Motion (ROM) – the therapist will move the joint(s) 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 will be noted. Often the muscle strength is graded.
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.

The therapist will develop a plan to treat your problems which will include how many times you should see the therapist per week, how many weeks you may need therapy, home exercise programs, patient education, short-term/long-term goals, and what is expected after discharge from therapy.

10. Is physical therapy painful?

One of the primary objectives in physical therapy is pain relief. This is accomplished with modalities such as ultrasound, electrical stimulation, therapeutic massage and/or heat or cold therapy. In addition, your therapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance. In cases such as knee or shoulder surgery, the techniques used for recovering range of motion may cause some pain. Therefore it is important that you communicate with your therapist so that your treatment plan may be adjusted.

11. Should I still come to therapy if I feel better or worse?

You should keep your appointment even if you are feeling better or worse. It is important for your therapist to know how you are feeling so they can make any necessary modifications to your treatment plan for effective recovery. However, it is not uncommon to feel some soreness after a treatment session.

12. What types of treatments will I receive?

Some of the following treatment interventions may be used:

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 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.

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.

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.

Whirlpool – immersion of a body part into water with small “agitators” to provide a gentle massaging motion. A warm whirlpool provides relief from pain and muscle spasm and is often preparatory to stretching or exercise. Cold whirlpool is used to decrease inflammation and swelling.