Frequently Asked Questions
1. What is Physical Therapy?
Physical Therapy (PT) helps you recover lost function in your body after an injury, accident, or surgery. The goal of PT is to help you return to your prior level of function, restoring your quality of life. A Physical Therapist evaluates your mobility, flexibility, strength, balance, and quality of movement. From your evaluation, your Physical Therapist finds a list of impairments that they will address through therapeutic corrective exercise, stretching, gait training, movement retraining, and balance exercises. Your program will progress both in the clinic and at home.
2. Do I need a referral or prescription from my Physician to start Physical Therapy?
No, in the state of California Physical Therapists operate under Direct Access Advocacy. This allows us to see you for ten visits or forty-five days (whichever comes first) without a referral or prescription. We can evaluate, treat you, and if something warrants the need to follow up with your Physician, we may suggest that. If not, we can get started on a plan of care and a personalized program to address your impairments.
3. Will insurance cover your Physical Therapy?
Medicare Patients
Medicare coverage may vary based on your plan – no two policies offer the same coverage.
* For those with a “Medicare Advantage” plan, you will most likely have a copayment for each visit.
* For those with a traditional “Medicare + Supplement” plan, you will have an annual deductible to meet (this amount changes each year). Some supplemental plans will pick up the deductible, others will not. Generally speaking, once the deductible has been met, 80% of your visit will be covered by Medicare and the balance will be picked up by your secondary insurance. If you only have Medicare without a supplemental policy, you will have to meet your deductible and then pay 20% of the visit.
* Finally, there are atypical Medicare policies that are neither “advantage” nor “traditional” – it is at those insurers’ discretion how much they will pay per visit. Please note that HMO plans often do not cover PT and you will be responsible for the visit.
Non-Medicare Patients
If you are not on Medicare, we are considered Out-of-Network with most commercial insurance companies. It is in your best interest to contact your insurance company to see what your Out-of-Network benefits are. Key questions to ask your insurance are:
* How much is your Out-of-Network deductible and is it met?
* Is PT subject to that deductible?
* What can I expect to be reimbursed if I submit a superbill?
* How many PT visits do you get per calendar year, per diagnosis, or per encounter?
* What is your Out-of-Pocket max and is it met?
Reimbursement will be between you and your insurer. We will provide a superbill, but will not contact your insurance on your behalf.
Whether you are “Out of Network” or have Medicare, we highly recommend reaching out to your insurance provider prior to your visit so that you fully understand your policy.
4. What happens during a Physical Therapy Session?
The 3 E’s. Evaluation: we are always assessing changes in your subjective measures (pain levels, function, sleep, etc) and objective measures (range of motion, strength, flexibility, and quality of movement). Exercise: PT always involves a progressive exercise program, from a low-level stretch all the way to a loaded squat. Education: there is always an element of patient education to help you discover what you are doing on a daily basis that could be contributing to your problem. Your PT may need to re-educate you on how to get in/out of a chair correctly and move pain free. After, you may receive modalities which are rehabilitation technologies, for example electrical stimulation to improve muscle activation or vasopneumatic (Game Ready) compression ice machine to reduce pain, swelling, and inflammation.
5. When should I start PT?
The answer is sooner rather than later. Typically after orthopedic surgery you start PT within one week, unless you are receiving at home PT. If you have not had surgery and have had a nagging pain that has not improved in two to three weeks by PEACE and LOVE, PT may be warranted. Addressing pain and impairments earlier leads to less damage-causing compensation, fewer complications, and fewer other aches and pains.
6. How long will it take to see changes?
It depends. There are many variables that come into play that determine how quickly you’ll see improvements. Your healing time may be affected by your overall level of health and wellness, predisposed medical complications (diabetes, dementia, cancer, etc), your age, your fitness level when you started PT, the length you have been impaired prior to starting PT, and compliance with your prescribed home exercise program. You may feel some improvements in strength by week three due to improved muscle activation, but typically true strength improvements take six to eight weeks. Note, it can take up to two years for tissues to fully heal, get rid of muscle atrophy, and recover full strength.
7. How long do I have to do my exercises for?
The answer is forever. Once you have weakened a muscle, tendon, ligament, cartilage, or a joint it will be your forever project. You may not need to perform all the exercises in your program forever, but think of your injured tissue as a lifetime project.
8. How many times do I need to come in?
No two people come to PT for the same reasons. Typically, if you have not had surgery, we can get you well on your way in six to eight sessions. We may space the sessions out over a two to three month period to allow for progression and independence with your home exercise program. On the other hand, if you have had surgery, you may need to come twelve to twenty sessions to get you back to your previous level of function. If you had a major surgery we typically like to keep our eyes on you for nine to twelve months, so we will spread the visits out over that period of time. Physical therapy tends to be more heavily loaded on the front end with weekly visits and may progress to a check-in one time per month to assess your progress. In between sessions you can always communicate with your Physical Therapist through the Physitrack app we set you up with at your first appointment.
9. Do I have to do the exercises even if they make me sore?
There is a difference between soreness and pain. Yes, your Physical Therapist may push you beyond your current limits or comfort zone a little bit, encouraging you to go beyond what you think you can do. This may lead to Delayed Onset Muscle Soreness (DOMS), meaning you will be sore the day after your PT session. If you perform your exercise and movements as directed, your tissues will adapt and get used to the load/demand you are placing on them and your soreness will decrease. If you only perform your exercises while at your PT session, you will likely continue to feel soreness and not meet your PT goals. On the other hand, if you experience pain, please let us know so we can re-evaluate.
10. Do you really only treat knees?
The answer is no. We treat knees and the joints above (hips) and below (ankles). The joints of the lower extremity (the leg) are all part of the kinetic/locomotion chain and have an effect on one another during movements.