If you’ve never had to be in physical therapy, we celebrate with you and hope you continue to stay healthy. However, if you need physical therapy, we want to be a resource for you!
As with any doctor’s office, it can be intimidating walking into a physical therapy clinic for your first visit, but we want to help put your mind and nerves at ease. If your physician, orthopedic surgeon, pain specialist, podiatrist, or family doctor refers you to physical therapy, here’s what you can expect.
What is physical therapy?
Merriam-Webster defines physical therapy as “therapy for the preservation, enhancement, or restoration of movement and physical function impaired or threatened by disease, injury, or disability that utilizes therapeutic exercise, physical modalities (such as massage and electrotherapy), assistive devices, and patient education and training.”
All physical therapy offices have at least one thing in common - the goal of helping patients heal & recover. With that being said, every physical therapy clinic is different! From one clinic to another, you may find different exercises, different equipment, different modalities, and more. Some clinics may focus more on exercise while others focus more on manual work. Here at Envision Sport, we combine manual work, therapeutic exercises, and modalities to help our patients in their physical therapy journey.
What does a typical therapy appointment look like?
As mentioned above, every physical therapy office is different. However, we will explain what a typical physical therapy appointment looks like at our clinic, Envision Sport Physical Therapy & Pilates.
At Envision Sport there are three main components of a typical physical therapy appointment:
Most people would refer to the manual work we do as a massage. The Physical Therapist (PT) or Physical Therapy Assistant (PTA) spends 15-25 minutes working on your affected area. The goal of manual therapy is to help reduce scar tissue, increase flexibility, reduce swelling, and improve mobility. Most of our patients enjoy the manual work and see improvement with their injured area rather quickly. Others who may have undergone a joint replacement surgery may not enjoy the manual work as much because it can be uncomfortable during the process of the helping you get your range of motion back.
Depending on your injury or condition, the Physical Therapist will come up with a plan of care designed specifically for you. This will include specific exercises targeted to help you return to your favorite things (i.e. baseball, gardening, playing with your grandchildren, etc.). While at Envision Sport, one of our Physical Therapy Aides will walk you through your exercises to ensure that you are completing them correctly and that your symptoms don’t increase. A typical patient will complete somewhere between 5-8 exercises during their appointment. An important piece to a successful Physical Therapy course of treatment is that the patient continues to do their exercises when at home. Although, we wish we could do all the work for the patient, it is crucial for the patient to continue their exercises at home in order to have a successful recovery.
There are several modalities that the physical therapist may recommend for the patient. Some of the modalities that we use include: electrical stimulation, IASTM, traction, ultrasound, the solo-step overhead harness system, taping techniques, laser, and heat & ice.
What are the different modalities and what do they do?
Often called e-stim or TENS, the electrical stimulation unit can be used in two ways; to help the patient with pain relief and to re-educate the muslces. When applied to help reduce pain, the patient will feel a tingling sensation (similar to having ants crawling on them). This sensation blocks or interferes with the pain signal that the nerves send to the brain. When used for muscle re-education, the TENS machine helps to contract the muscle that the patient is having problems contracting on their own.
IASTM As we’ve discussed in previous blogs, IASTM stands for Instrument Assisted Soft Tissue Mobilization. This instrument is used to help patients increase their range of motion and decrease pain. It works to break up scar tissue, as well. Link blog that dives into what this is
Traction - Traction can be used in some instances of back and neck pain. It can provide the patient some relief from their symptoms by creating space within the spinal column. However, there are reasons the physical therapist may not be able to use traction with some patients; such as those who have undergone surgery.
Not to be confused with diagnostic ultrasound, the ultrasound used in Physical Therapy is used to heat the soft tissues within the body. It is believed in the medical field that ultrasound can excel the healing process and decrease pain.
Solo-step Harness System
Most hospitals have this system and only some Physical Therapy offices have incorporated this modality into their practice. These harness systems are designed to help protect patients from falling while giving them confidence to maneuver certain obstacles in a safe environment. Physical Therapists use the overhead harness system to help patients improve their balance, gait, and everyday activities (i.e. walking, standing, and climbing stairs).
There are several different taping techniques physical therapists can use. The most common reasons that taping is utilized are to provide stability for the muscles/joints, stimulate the body’s natural healing process, alleviate discomfort, improve posture and the movement patterns.
All Laser Therapies are types of PBM (Photobiomodulation) Therapies. The most common Laser Therapies are Cold Laser and Deep Tissue Laser. Both stimulate the cellular process of regeneration and healing by utilizing specific light wavelengths. Deep Tissue Laser Therapy is only level IV lasers. These level IV lasers are able to penetrate more deeply into the tissue and can treat more severe conditions than the Cold Lasers can (which are Level II and III lasers). Both however, alleviate pains, aches, inflammation, speedup the healing process of chronic, acute, superficial skin conditions, and more.
Heat & Ice
Depending on your injury and symptoms, the therapist will have you either on heat or ice for the last 10 minutes of your session. If you have sprained your ankle, have tendinitis, plantar fasciitis, or IT Band Syndrome they will recommend ice. If you are achy, tight, or stiff, they will recommend heat because it stimulates blood flow to the needed area.
When a patient is just starting physical therapy, there are some common questions they have.
How long will it take to feel better?
As much as we’d love to give you a definitive answer, the truth is it depends on a few factors: the severity of the injury, the individual’s healing process, and how often the patient is doing their home exercises. We would say however, the average patient is in physical therapy for about 12 visits.
For example, if someone has undergone a joint replacement, their therapy is typically longer than someone who sprained their ankle. A patient who does their exercises routinely at home is more likely to discharge on time (or early) as they are proactive in their rehabilitation journey.
So unfortunately, the answer “it depends” is something you’ll hear quite often. Our goal is to get you back to doing the things you want to do as quickly as possible. As much as we love spending time with our patients, we also want to see them walk out the door feeling better, confident, and strong!
Is Physical Therapy covered by insurance?
The short answer, yes! If your doctor refers you to Physical Therapy (PT), most insurances will cover the PT. Keep in mind, that every Physical Therapy office is contracted with different insurance providers. Thus meaning they are only in-network with some insurance companies.
Another thing to consider, is that only certain offices will accept HMO insurances and others will not. In the event that you have an HMO plan and want to go to a specific Physical Therapy clinic that is out-of-network, they may offer you cash rates that do not go towards your deductible.
Do I need a referral to start Physical Therapy?
This is another question that has a the truthful answer of “it depends.” This depends on the state you are in and your insurance. You may actually be required to see a doctor prior to starting Physical Therapy.
For those of us in California, we have something called “direct access.” Meaning, under most insurances you are allowed to see a Physical Therapist for 12 visits, or 45 days (whichever comes first) without a referral. To ensure that you are allowed to go straight to a Physical Therapist, you can call your insurance provider to ask if a referral is required with your plan. Some Physical Therapy offices, like ours, will call your insurance company for you! Make sure you call the office you are wanting to go to for PT and see if the front desk can verify your benefits; but don't forget to tell them that you are specifically inquiring as to whether, or not you need a referral.
At Envision Sport, we want physical therapy to be as enjoyable as possible! If you have questions about what physical therapy is, what to expect, or even a question about your injury - we want to be a resource for you. Our goal is to help you get back to the things you love doing, with lasting results, as quickly as possible!