Physical Therapy: What is it?
Physical therapy (PT) helps people recover from surgery, an accident or injury, return to sports and hobbies, or playing with your kids or grand kids. PT also helps when a person’s body is not functioning at what is considered normal for them—perhaps they had back pain, a bout of vertigo, recent surgery or fall; or are dealing with a neurological disease; or even facing aging and loss of mobility. Physical therapy helps when the body is changing in a way that is affecting function and quality of life.
A physical therapist evaluates a person from the standpoint of their mobility, function, balance and strength. What are they having difficulty doing? What do they want to get back to doing? The basic premise of physical therapy is that you’re looking at the person’s physical dysfunction and determining the steps to take to improve the person’s physical condition.
What do we do in a therapy session?
There’s always an element of patient education to help people discover what they are doing on a daily basis that could be contributing to their problem. The physical therapist may need to re-educate a person on lifting something correctly or moving properly. During a PT session, the therapist usually applies hands-on techniques such as joint mobilization for a stiff joint, soft-tissue work to improve flexibility and decrease muscle spasms.
PT always involves exercises of some sort, from a low-level stretch all the way to a well-rounded strengthening program. Physical therapy modalities are rehabilitation technologies that relieve pain, reduce swelling, decrease muscle spasms and improve circulation. These modalities include ultrasound, trigger-point pressure, soft-tissue oscillation, electrical stimulation, heat and ice.
Why do I have to do these exercises?
Physical therapists sometimes push people beyond their limit or comfort zone a little bit, encouraging them to go beyond what they think they can do. Physical therapists try to look at things objectively and implement different tests with patients. We try to empower people to kind of fix themselves. We don’t want them to have to keep coming back.The goal is get people to a point where they can maintain themselves and do their exercises at home or at the gym and go on with their lives. We push people so they can be independent and not reliant on us, medication or other treatments.
How long will I be coming to therapy?
Physical therapy is not a quick fix. People in general are looking for that quick fix. PT follows the way our anatomy and bodies operate. There’s a certain amount of time that is required for certain types of tissue in the body to repair themselves. If you try to speed up the process, you could experience a re-injury. So physical therapy takes some patience and perseverance, and you’ve got to keep up with the program to experience the gains. Physical recovery happens in stages, and you have to be present for the whole program, from beginning to end, if you want lasting results.
Do I really have to do home exercises?
Usually people go to therapy only two or three times a week depending on their insurance and payment options. The responsibility for improvement falls on the individual, too. The stretching and strengthening exercises are really something that has to be done almost daily. You’re not going to get the progress or improvement you need just relying on going to your therapy visits, so you have to do exercises at home. And, by the way, we can always tell if someone is being good about doing his or her home exercise program or not.
What’s the difference between physical therapy and occupational therapy (OT)?
Physical therapy deals with the entire body, anywhere from the inner ear and vision to the arms and legs. Physical therapists look at the body as a whole and are focused on getting people up and walking and working on balance, overall strength and core strength. Occupational therapy specializes a little more in the upper extremities, arms and hands. OT is very task-related and goes more into depth with someone’s fine motor skills and memory-type exercises and cognitive strategies.
How is physical therapy treatment performed in the home?
You can implement all of the usual techniques, but doing joint- or soft-tissue techniques can be a bit of a challenge because it’s easier in a clinic with an adjustable table to get people in the right positions. When you’re in someone's home, you have to adapt to best suit the needs. You have to evaluate their homes and make suggestions on how to rearrange furniture and household items to make their home as safe as possible. Or you suggest adaptive equipment or even home modifications. I bring the necessary equipment, including a treatment table, and improvise when necessary.
Will I definitely improve with physical therapy?
I think that everyone, to an extent, will experience a certain level of improvement. That’s if the patient is putting forth the effort that they can, and, of course, the therapy team is doing everything they can. But even though you’ve done everything you can, not everyone gets significantly better.
More often than not, people do not return to the way they were prior to whatever event they faced. Once the body sustains a trauma, it really doesn’t completely go back to the way it was. So there’s a level of education in explaining how the body heals itself and how scar tissue can limit movement. For example, with a bone fracture, the bone does not look like it did before it broke. Physical therapy tries to optimize that person’s function and environment so they can hopefully continue to live independently and get back to things they enjoy and find purpose doing, whether it’s a job, hobby or just being able to participate in activities with their kids or grandkids.
How does physical therapy adapt for older adults?
The timeline of healing and recovery is going to be longer, because with the aging process, seniors don’t heal as quickly as someone younger. Mobility is important at every age. You look at the individual, what their life is like, how active they are and their motivation. You may not be as aggressive with some of the exercises for seniors, but you continue to treat them like you would anyone else. You just expect their physical recovery to take longer.
Why choose a sole practitioner physical therapy practice?
You go to a physical therapist to improve your situation, whether it be to relieve pain, gain mobility, or resume activities that you have had to curtail. You want the most effective treatment solutions tailored to your needs, applied by an experienced and skilled practitioner. In the small practice, the relationship with the patient and the outcome drive the treatment. The practitioner is your advocate, spending the necessary time and attention to progressing you toward your goal at the pace that is best for your particular outcome.
In a corporate setting the numbers drive the treatment. You, the patient, are seen for only a few minutes per treatment session, usually while the same therapist sees other patients sharing the same time slot. In many corporate practices, the therapist that you see may differ from appointment to appointment, each with a varying level of experience and skill level.
Will I see only one therapist for all of my appointments?
Yes! Continuity of treatment is a key factor to a successful recovery. I will personally monitor and evaluate your progress. We will work together for the entirety of your treatment to accomplish your goals.
Am I going to be the only patient being treated during my treatment session?
Yes! 100% of my attention is focused on listening to you, answering your questions, performing your exercises with proper form and monitoring you while you exercise and stretch. This approach empowers you to have confidence when doing your home exercises and speeding your recovery.
I have Medicare. How many visits of physical therapy am I allowed per year?
There is no set number of visits that you are allowed by Medicare per year. Medicare allows a certain dollar amount, or therapy cap limit, per calendar year. The current cap limit is $2040 for physical therapy and speech therapy combined. At each visit, you will be notified as you approach the cap limit. Should you reach the limit, I will discuss with you your progress toward your goals and your options for continued treatment.
Will Medicare cover home health care and outpatient physical therapy at the same time?
If you are receiving any type of home health care (ie in-home physical therapy, home health aide, visiting nurse service, wound care, blood draw, etc) Medicare will not pay for outpatient physical therapy. Once you have been discharged from home health care services, you are then eligible to receive outpatient physical therapy.
Can I receive physical therapy treatment without a prescription from a doctor?
After an evaluation, you can receive treatment for up to 10 visits or 30 days, which ever comes first, without a physician's prescription. My fee is $125 per visit. After the 10 visits, you must obtain a prescription from a physician in order to prove medical necessity.
Medicare requires a physician's prescription in order to prove medical necessity and pay for your treatments.
Does Medicare part b have a deductable?
Medicare Part B benefits include (but aren’t limited to) doctor’s office visits, preventive screenings, and durable medical equipment. For some of these services, a deductible will apply, and Part B deductible is $185 in 2019. Often, you will pay 20% of the Medicare-approved amount for a health-care service after this deductible is met.
You can find out more about Medicare Part B here.
What if I do not have insurance?
If you do not have insurance, you can receive treatment on a cash-pay basis. Please call me to discuss your options. There are ways that I can work with you to get the treatment that you need.