It is a good idea. Pain is your body telling you something is wrong. Pain will usually occur when tissue is under excessive stress or repetitively irritated. Tissue that is under abnormal stress will begin to deteriorate and eventually fail. By addressing the issue early on, you are preventing further, and possibly irreparable, damage. By correcting dysfunction, you will likely avoid unnecessary medication, injections, surgery or stress on other parts of your body. You will save yourself and the healthcare system money by reducing the need for unnecessary office visits and the potential for future problems.
A good method is to find someone with experience. There are a lot of fancy certifications and easy ways for practitioners to get more letters behind their names, but if they haven’t spent time practicing the skills, then they aren’t necessarily a better therapist. Many therapists will have years of experience with certain conditions and not have the extra letters or certifications. Other therapists will have dabbled in this or worked a little with that. In most cases, a therapist who has worked with the same population for most of their career will be able to better treat the condition.
The biggest difference is in education. Physical therapists have a much more in depth understanding of injury, in all stages. They also understand more about the process of tissue repair, the physiology and kinesiology of muscles, joints and soft tissue. The amount of education and training is usually much greater for therapists – the minimum requirement to become a therapist is a Masters degree whereas anyone can be a personal trainer in a weekend. A degree in athletic training can be obtained in as little as 3 years. Therapists have to pass a national examination and be approved by a state board in order to practice. In the state of Maryland, athletic trainers and personal trainers have no such requirement.
Your first visit is primarily a “fact finding mission,” taking measurements, asking questions and finding out what impairments we are dealing with. We will then explain our findings and go over a treatment plan that should give the patient an idea of how we will try to make it better. Each subsequent visit will usually involve massage/manual therapy, stretching, joint mobilization, exercise and possibly modalities like heat and electrical stimulation to address pain. A typical appointment will last 60 minutes with the therapist spending a minimum of 20 minutes 1:1 with a patient followed by some light exercise. Sessions can be longer as exercises progress, or if a therapist chooses to spend extra time with the manual portion of the treatment.
It is best if the therapist can access the treatment area, so loose and comfortable clothes are best. Usually shorts and a T-shirt are fine, women may want to wear a sports bra. We have clean gowns and shorts for our patients, just in case.
If your condition is improving, we will try tapering treatment and encouraging each patient to resume activity as they would have, prior to injury. Usually in the last visit or two, there will be a “plan” that outlines further steps for a patient to take after therapy is over. If patients are doing well but are not comfortable with the idea of returning to a gym or exercising independently, we offer use of our facility as part of a wellness program where there is access to modalities and skilled supervision. Lastly, our therapists are always happy to advise patients via email or telephone, to further help them during return to function.
Most injuries are usually the result of trauma or excessive forces on certain structures in your body. While medications and other interventions make it feel better, they are not addressing the source nor assisting your body in the repair. Therapy will make every attempt to isolate the source of the abnormal forces and correct them. Treatments will aim to create an optimal environment for which your body can repair itself. After that, it is up to the individual to avoid damaging motions and to sustain healthy lifestyles while the repair process occurs.
In most cases, we try to avoid this. Our opinion is that by seeing the same therapist or the assistant, you will get more consistent treatment and the therapist can better understand how your particular body responds to the treatments. Despite strict and thorough documentation standards, it is still very hard to give the same treatment as another therapist – this is especially true with manual therapy. So, unless you like the idea of trying something a little different each session, we try to schedule our patients with the same therapist or assistant throughout their care.
We participate with almost all of the commercial insurance plans in the state of Maryland. If we do not participate with your plan, we will investigate what avenues exist in order to commence treatment. We will always verify your benefits to see exactly what coverage our patients have, prior to the first appointment. That way, there are no “surprises.”
One of our most important goals is to help people. If you do not have insurance, or are covered by a plan we do not accept, we are willing to work out an arrangement that enables access to our facility and treatment from our providers.
You should always ask your providers if they participate, or are “in network” with your insurance. What that means it that the facility has a contract with your insurance to accept predetermined fees for a service. It also means that the facility can not bill the patient for amounts beyond those preset fees. “Accepting” insurance means nothing more than they will accept you as a patient, and often means you will end up paying more out of pocket.
No. You have rights as a patient to choose your place of care. In fact, it is illegal for anyone to mandate you to use a certain facility. Your doctor should consider the convenience of access, skill level of clinicians and specialties provided before making a referral – but many times they don’t. Many case adjusters will try to “steer” patients towards a facility that gives them the largest discount. The fact is: a patient is entitled to choose a facility that suits their needs best.
While there is no difference in the basic functions of each office, there is usually a difference in treatment philosophy – which may affect your recovery process. Many physician and corporate owned offices offer incentives to their therapists to treat as many people per day as they can. Some even sort their patients by insurance so that therapists spend more time with better paying policies. There have been competitions between these clinics to see who can average the most charges per day. In the end, it may mean you have been given a lesser quality of treatment or had your time cut short. Private practice permits its therapists time to do what is best for the patient, regardless of time or insurance as long as it is justified and an accepted treatment for the condition. Therapists in private practice will tend to have more experience, be permanent employees and have the ability to follow you from start through finish of your rehab.