Why are people referred to physical therapy?

You and others may be referred to physical therapy because of a movement dysfunction associated with pain. Your difficulty with moving part(s) of your body (like bending at the low back or difficulty sleeping on your shoulder, etc.) may result in limitations with your daily activities (e.g. difficulty getting out of a chair, inability to play sports or trouble with walking, etc.). Physical therapists treat these movement dysfunctions and their associated pains and restore your body's ability to move in a normal manner.

What do physical therapists do?

You have probably heard of the profession of physical therapy and you might even know someone who needed physical therapy after an injury. More so, you might even have been treated by a physical therapist yourself. But have you ever wondered about physical therapists - who they are and what they do? Many people are familiar with physical therapists' work helping patients with orthopedic problems, such as low back pain or knee surgeries, to reduce pain and regain function. Others may be aware of the treatment that physical therapists provide to assist patients recovering from a stroke, that is, assisting them with recovering use of their limbs and walking again.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 known as 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 through the use of specific therapeutic interventions.Physical therapists also 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.

In addition, they 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 at our clinic 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, backs or general fitness level.The cornerstones of physical therapy treatment are therapeutic exercise and functional training. In addition to "hands-on" care, physical therapists 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 soundwaves 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.

Why is physical therapy a good choice?

More than half of all Americans suffer from pain, whether it is a recent episode or chronic condition. Pain often accompanies a movement disorder and physical therapists can help correct the disorder and relieve the pain.However, many people do not know that physical therapists are just as equally equipped as many physicians to perform a detailed orthopedic evaluation and provide conservative, non-invasive treatment as an alternative to injections, medications and surgery.

What can I expect on my first visit to Advanced Care?

Please arrive 10 to 15 minutes prior to your initial evaluation in order to complete the appropriate paperwork. At that time, our office staff will review your personal explanation of rehabilitation benefits quoted from your insurance provider. You will then be evaluated by one of our licensed professional physical therapists.Your evaluation will be an individualized session in which the clinician will perform a comprehensive evaluation assessing your impairments and functional limitations. Based on his/her evaluation, you will be consulted on your diagnosis and your questions will be answered as necessary. You will also be issued a home exercise program that is individually constructed by your clinician for you.

Who is involved in my rehabilitation?

Your rehabilitation will be overseen by your physician and supervised by your physical therapist. However, during your treatment there may be other staff members, aside from your clinician, who will assist you. These persons may include physical therapy assistants who work under the direction of your PT to provide you with the best possible care.Advanced Care Physical Therapy's primary objective is to help you achieve your rehabilitation and treatment goals and prevent further injury/dysfunction. After a comprehensive evaluation, goal assessment and treatment plan, you will be scheduled for a return visit(s) based upon your physician's and clinician's recommendations.

What can I expect from my physical therapy assistant?

Physical therapist assistants (PTAs) provide physical therapy services under the direction and supervision of a physical therapist. PTAs help people of all ages who have medical problems or other health-related conditions that limit their ability to move and perform functional activities in their daily lives.PTAs work in a variety of settings, including hospitals, outpatient clinics, home health, nursing homes, schools, sports facilities and more. PTAs must complete a two-year associate's degree and are licensed, certified or registered in most states.Care provided by a PTA may include teaching patients/clients exercise for mobility, strength and coordination, training for activities such as walking with crutches, canes or walkers, massage and the use of physical agents and electrotherapy such as ultrasound and electrical stimulation.

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.

Cold Laser - FDA-approved laser therapy treatment that provides patients with a safe, effective and painless therapy that uses the body's own natural healing systems to relieve pain, increase joint mobility, increase tissue integrity and promote cell regeneration. The laser works by supplying energy to the body in the form of billions of photons of light, which the body absorbs on a cellular level and transforms into chemical energy that is used to repair damaged tissues.

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 IS also an effective pain reliever for even the most chronic pain.

Functional Retraining - A hallmark of what we do at Advanced Care PT, utilizing the concepts of Gary Gray, in which patients simulate activities of daily living and receive instruction in proper body mechanics and energy conservation techniques. As part of a functional restoration program, patients will perform exercises that will carry over into daily living activities.

Gait or Walking Training - The analysis of walking problems by visually examining the interaction of the trunk with 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.

Heat - Heat is recommended to decrease chronic pain and relax muscles and for pain relief. It should not be used with an acute or "new" injury. Heat increases blood flow to the site and improves oxygenation to restricted tissues. Heat is also beneficial for chronic conditions/inflammation due to its circulatory benefits.

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.

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, Paris, Isometric Mobilizations, etc.

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.

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).

Pelvic/Lumbar Traction - The longitudinal/axial pull on the lumbar spine, either manual or mechanical, intermittent or continuous. Pelvic traction may be helpful for the relief of low back pain and muscle spasm.

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.

Proprioceptive Neuromuscular Facilitation (PNF) - A system of manually resisted exercises performed in diagonal patterns that mimic functional movements. Initially used in developmentally and neurologically impaired patients but now used in almost every aspect of neuromuscular retraining from athletes in sports facilities to the very weak in hospitals and nursing homes.

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, to improve range of motion and for pain relief.

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.

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 compensating for pain, spasm or immobilization.

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 high-frequency soundwaves 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 soundwaves are pulsed, they cause a vibration of the tissue rather than heating. The stream of soundwaves 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.

How long will each physical therapy session last?

Although it depends on your condition, an initial evaluation will last approximately 60 minutes and each follow-up session will last approximately 45 to 60 minutes.

How long will I go through therapy?

Although it depends on your diagnosis and general condition, your follow-up appointments may consist of:

  • Therapeutic exercises
  • Manual therapy
  • Soft Tissue Mobilization
  • Modalities
  • Reviews of your home exercise program and your goals

In about four to six weeks, your physical therapist will complete a Progress Summary that will either be mailed or faxed to your physician. This letter will inform your physician of your progress in therapy and will generally give one of the following recommendations:

  • A request for the approval of additional physical or occupational therapy for a specified amount of time.
  • A recommendation to discharge you from therapy with a home program or referral to our supervised fitness program.

What should I bring to therapy?

You should wear loose-fitting clothing so you can expose the area that we will be evaluating and treating. For example, if you have a knee problem, it is best to wear shorts. For shoulder problems, a tank top is a good choice, and for low back problems, wear a loose-fitting shirt and pants so we can perform a thorough examination. If you do not have the appropriate clothes, we can provide you with a gown or loose-fitting shorts. Sneakers are recommended for your physical therapy sessions.

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 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 happens if my problem or pain returns?

Flare-ups are 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.

Do you offer aquatic physical therapy?

Yes, we have a heated therapeutic pool approximately 30 ft. by 14 ft., with stairs leading into the pool, arm-railed assistive chairs for easier access getting in and out of the pool, as well as a Hoyer lift to assist wheelchair-bound and other non-ambulatory patients. The pool is divided into depth levels of 4 ft. to 4-1/2 ft., with one level at approximately 6-1/2 ft. deep.

What is aquatic physical therapy?

Aquatic physical therapy is the practice of physical therapy by a trained and licensed physical therapist or physical therapist assistant within the environment of a water-filled pool. The support, buoyancy and accommodating resistance of the warm water enhance exercise and create a safe environment for progressive rehabilitation. The warm water temperature (93 degrees F) prompts muscle relaxation, facilitates stretching and generally reduces the sensation of pain.Treatment sessions are designed to improve circulation, strength and endurance, balance and coordination; increase range of motion; decrease tissue swelling; normalize muscle tone; protect joints during exercise and reduce stress. Typical problems and conditions that can be effectively treated through aquatic therapy are injuries to the neck, shoulder, low back, knee and ankle; chronic pain; arthritis; fibromyalgia; neurological disorders, such as cerebral palsy and multiple sclerosis; and conditions limiting the body's ability to bear weight, such as postsurgical dysfunctions.

Can I go to any physical therapy clinic?

You have the right to choose any physical therapy clinic as long as they are providers for your insurance. 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. We are providers for most insurance companies.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, including New York, 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 and/or 10 treatments, the therapist will refer you back to your physician.

What happens if I am running late?

If you are running late, please call as soon as possible. We ask that you be on time to all appointments; however, we do understand that situations arise where you may be late. Call and let us know and we will do our best to accommodate you. As a courtesy, please give 24-hour notice for any cancellations or reschedule appointments that you may have.

Who pays for the treatment?

In most cases, health insurance will cover your treatment. We accept many insurance plans, Medicare and Worker's Comp. Feel free to call our office to see if we participate with your health plan. If so, our receptionist can help you clarify your insurance coverage. Most insurance companies require you to pay a co-pay that will vary from plan to plan. Co-payments are collected at each visit when you sign in.

How long does the billing process take?

Once you have scheduled your appointment and given us your insurance information, we will begin the process of verifying your physical therapy benefits with your insurance company. As a courtesy, you will receive a copy of the benefits as quoted from your insurance company to us. Please note that insurance quotes are not a guarantee of benefits. The following is intended to help you better understand our billing process:

  • Co-payment is expected at the time of treatment.
  • Your daily charge is sent by your therapist to our billing office.
  • The billing office then submits these charges to your insurance company for reimbursement.
  • Advanced Care generally receives payment within 30 to 60 days.
  • Advanced Care will submit a bill to you after your insurance has paid or made a decision on services rendered (usually within 30 to 60 days)

We encourage you to contact and verify your benefits with your insurance company. Please feel free to contact our medical billing specialist if you would like a record of your charges prior to receiving your bill. Although it may take 30 to 60 days to receive a bill for your deductible and co-insurance, all co-pays are expected at time of service. We appreciate your understanding and cooperation.

How can I provide feedback?

Please communicate your needs or questions to your clinician at any point. Advanced Care Physical Therapy, Aquatic & Fitness Center takes all feedback from patients seriously and appreciates your input. At some point during or after your rehabilitation, we encourage you to complete a Patient Satisfaction Survey either online or at the clinic.If you have any additional questions or comments for your therapist, you can locate their email address on their business card or access their email address through our Team Member Page.

Do you offer gift certificates?

Gift certificates are available for purchase within the Advanced Care Physical Therapy, Aquatic & Fitness Center facility. Gift certificates can only be redeemed for the services listed and cannot be used as cash toward other services. Gift certificates are non-refundable and must be redeemed within one year from the date they were issued.

What are your payment policies for services such as soft tissue mobilization, personal training, performance enhancement, gift certificates or fitness center memberships?

Payment for all services must be made in full before services are provided. If you have an existing account on file, these services can be automatically deducted from your account. If you have not set up an account with us, you will be asked to provide us with a valid credit card.

What is your refund policy on fees for services such as soft tissue mobilization, personal training, performance enhancement, gift certificates or fitness center memberships?

All services purchased are non-refundable. We will not refund the full or partial price for any unused services, packages or gift certificates purchased.

What is your cancellation policy for fees for services such as soft tissue mobilization, personal training, performance enhancement, gift certificates or fitness center memberships?

All Advanced Care Physical Therapy, Aquatic & Fitness Center clients must give 24-hour notice for cancellation or rescheduling of their appointments. Please be prompt for your scheduled appointments. This is for the benefit of you, other clients and the therapist/trainer/instructor. When able, please schedule your appointments in advance to ensure the times you need.