What is Physical Therapy and is it Appropriate for Me?

As our country struggles with economic hardship and the cost of healthcare continues to climb, the cost-benefit of direct access physical therapy services is more evident.  Direct access refers to the ability of a patient to access physical therapy services without a physician's referral.  Thus, patients with pain and musculoskeletal deficits do not have to report to their primary care provider in order to receive a prescription for physical therapy.  Instead, they can report directly to a physical therapist, an expert in biomechanics and musculoskeletal injuries, without any major restrictions or physician referrals.   Florida is one of the few states that allow direct access to a physical therapist without any major restrictions.  Clearly, physical therapy is by no means the cure for every condition, but it can provide quick, effective results at a minimal cost for many musculoskeletal problems. 

It is also critically important to address medical conditions as early as possible in order to avoid chronic pain and to optimize therapeutic outcomes.  A recent physical therapypublication found that “less than 5% of shoulder rotator cuff tears are due to traumatic and single-injury mechanisms, whereas 95% of all tears are due to gradual wear.”  For example, addressing the biomechanics of the shoulder at the earliest signs of pain through physical therapy will help to prevent a full muscle tear; thereby optimizing successful treatment, preventing further injuries, and ensuring independent, long-term management of the condition.  Physical therapists are the experts in biomechanics and motion, and we help patients to function by using latest techniques to treat and prevent musculoskeletal injuries, thus improving your quality of life.

The physical therapy profession continues to grow, advance and adapt to modern health care needs into the 21^st century.  The purpose of this post is to make people aware of ALL options when seeking medical care, and that physical therapy is easily accessible, cost effective, and a clinically powerful alternative for many orthopedic conditions.  Just ask any of the individuals that have already been treated at Pursuit Physical Therapy.  The Pursuit Physical Therapy staff has unmatched academic credentials and experience treating a variety of orthopedic conditions, chronic pain, back pain, sport-specific rehabilitation, and golf swing analysis.  Moreover, Pursuit Physical Therapy prides itself on promoting only the very best evidence-based practice with optimal patient care, and patient satisfaction.  Pursuit Physical Therapy promotes the vision of the future of physical therapy, which is physical therapy provided by doctors of physical therapy, recognized by consumers and other health care professionals as the practitioners of choice to of which consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function, and health.  Visit www.pursuittherapy.com or Pursuit Physical Therapy at 407-494-8835 for more information regarding physical therapy and how we can help you get out of pain!

Exercise is medicine!

Physical Therapy for Acute Low Back Pain? Can This Work?

Lets review this example of low back pain (LBP), that I happened to go through over the past 4 days.  So, for some reason, I decided to go to the gym on Tuesday and perform deadlifts as a part of my workout, which I haven't done since last year.

So later that day, after working at a skilled nursing facility and driving to my other job, I noticed an increase in LBP with strong muscle spasms.  Pain is a good thing (yes, it is very important!) and it tells you that something is wrong.  I always tell patients to "listen to your body", and if you are doing a certain task or position and you have increased pain try to avoid this, stop that activity, or attempt to complete it in a different position.  It is accepted in the research that acute LBP will spontaneously resolve in 4-6 weeks, but who wants to wait that long?   I know what caused my pain and that starting treatment with physical therapy with acute LBP as soon as possible will show better outcomes, decrease unnecessary testing, decrease the cost of healthcare, and I can start my treatment now!    So I was flexion sensitive, meaning I probably injured my low back during the deadlift during a flexion activity, driving also increased my pain (a flexion position again), and I know that prolonged sitting, bending forward, and any lifting would all increased my pain.

 I attempted to avoid these position as best I can, but as I was seeing patients, my work required me to be in some of these positions.  So I began treatment by myself throughout the day ... by doing prone press ups!

Since I was flexion sensitive, I would treat my LBP with repeated extension.  Many people with acute LBP fall into a directional preference and you can treat this with repeated motion with good research to support this.  I would perform at least 1 x 10 of prone press ups every hour to help me get through my day.  When I got home I usually sit in my chair, send some emails, and watch TV with my wife, but I knew that sitting would increase my pain, so I decided to do this.

I watched TV and checked my emails in this position, and by the time I was done I had no LBP!  This remained throughout the night and the next morning, and I was able to do a run/walk the next morning with only some muscle tightness.  I continued throughout my workday to perform at least 1 x 10 prone press ups every hour and was able to get through my day without exacerbating any symptoms.  On the 3rd day, I was able to return to the gym and perform basic strengthening during a light workout.  I could say that on the 3rd day I was pain free with no muscle spasm with no increased pain with flexion activities or prolonged sitting.  I know that this case will not work for every case of LBP, but this is a perfect example with acute LBP how early access and treatment with physical therapy can greatly help your pain and show a great outcome faster than the standard.  Physiopedia is a great online resource regarding physical therapy and LBP.  Pursuit Physical Therapy also has posted free information regarding LBP on their patient perspective page that reviews how LBP with effect their treatment and care.  Don't wait 4-6 months until your acute LBP to resolve, call Pursuit Physical Therapy at 407-494-8835 or visit us at www.pursuittherapy.com and start your treatment today!

Achilles Tendinitis: Can Physical Therapy Treat This?

Achilles tendinitis is a common injury that many athletes and non-athletes experience.  It may be caused by too much stress to quick to the Achilles tendon (like running for the first time) or too much stress over time that is associated with a lack of calf flexibility or a work related activity.  Many believe that this is an inflammatory condition but research shows that this is more of a degeneration of the tendon and not an inflammatory condition.  This is why sometimes, NSAIDs and other anti-inflammatories don't help with treatment.  Physical therapy has been shown to have great outcomes with Achilles pain and have been recommended as the first line of treatment.  When treated with manual therapy, stretching, and strengthening, your pain and symptoms should begin to decrease within the first couple of visits.  Some patients have even been pain free in 2-4 visits!  For more chronic Achilles pain, treatment may takes longer, even up to 4-6 months, but a good outcome is expected. Physiopedia has a great resource and tool kit regarding information, diagnosis, and best treatment for any achilles tendinitis or tendinopathy.   Visit www.pursuittherapy.com or call Pursuit Physical Therapy for more information regarding the treatment of Achilles pain and what is the best treatment for you!

Common Cross Fit Injuries?

What are some of the most common Cross Fit Injuries?  We really want to get involved in some of the local Cross Fit gyms around Central Florida. Injury prevention, training with proper biomechanics with the squat, deadlift, clean, and jerk lifts, and assisting with evidenced based treatments may help prevent an injury from occurring and, if injured, we can help you to get you back to Cross Fit pain free faster than the standard.  Feel free to comment on this blog, on the Pursuit Physical Therapy facebook page, or via email at pursuittherapy@gmail.com.   Visit our website at pursuittherapy.com for more information!

We are on Pinterest!

Pursuit Physical Therapy is on Pinterest now!  This will be a great way to share pictures of exercises, treatments, and to help with home exercise programs.  Follow us on Pinterest or visit the Pursuit Physical Therapy website for more information.  Starting a new standard of health care!

Press Release: Grand Opening

Physical Therapy Clinic

Offering Direct Access and Evidenced-Based Care

Opens In Maitland

ORLANDO, FL.--April 16, 2013 Pursuit Physical Therapy is proud to announce the grand opening of their physical therapy clinic at 1000 North Maitland Ave, Maitland, FL.

Pursuit Physical Therapy Clinic wishes to set the new gold standard in physical therapy.  “We will pursue better outcomes, faster results, and a better quality of life for our patients by offering direct access to high quality evidenced-based care from board certified specialists,” explains owner Dr. Ron Miller, DPT, OCS.   The clinic is a cash-based practice and no physician’s script is required to make an appointment.  “By eliminating health insurance limitations and guidelines, patients can receive one-on-one patient care, with no restrictions with your treatment, receiving a better outcome in fewer visits.”

Starting May 6^th, the clinic will be open Monday thru Friday and will offer early morning and evening appointments.  Weekend appointments are also available if needed.   The clinic will specialize in the treatment of neck and low back pain, spinal disorders, sport injuries, manual therapy and golf related injuries.   To make an appointment please call 407-494-8835 and for more information visit www.pursuittherapy.com.

Dr. Miller is credentialed by the American Physical Therapy Association (APTA) as a Board Certified Physical Therapist and certified through the Titleist Performance Institute for golf swing analysis and the treatment of golf related injuries.  Dr. Miller is also an active member of the APTA, Florida Physical Therapy Association (FPTA), American Academy of Orthopaedic Manual Physical Therapist (AAOMPT), and is currently elected to the position of Vice Chair, for the East Central District of the FPTA.

What is the Key to Generating Power in a Golf Swing?

So after you have treated your LBP and you have a pain free golf swing, what is the key to generating power?  EPSN Sports Science did an excellent clip on the importance of the kinematic sequence with Rory McIlroy, breaking down the basics to the kinetic chain.  How can someone who is 5'9" and 160 lbs drive the ball 300+ yards?  Well, the KEY TO POWER is the kinetic chain and the ability to improve the transfer of energy from the hips, to the trunk, to the arms, and through the club.

The graph above is an example data that you can gather with a 3D golf swing analysis.  Each line dictates a different body part.  With the golf swing, and ideal sequence is needed, and thus you get a graph like this.  Now the transfer of energy is measured with the downslope of each line after the peak of each body part.  This measures the deceleration of each joint, or the transfer of energy.  Increase slope = increased energy transferred.  This dictates the power you can generate with your golf swing.  You can train yourself to improve the neuro-muscular control and strength of each body part with the proper training and specific exercises.  With the proper exercises you can become more efficient at transferring energy with your golf swing, thus hitting the ball farther, and decreasing your scores! You don't need to have pain to consult Pursuit Physical Therapy.  Call now and schedule a golf swing consultation and start generating power with your golf swing!

Are you ready for the Masters!

In honor of the Masters this week, we are posting about the golf swing and pain all week.  Checkout the Pursuit Physical Therapy facebook page for our daily golf posts.  How do you decrease low back pain with your swing?  What impairments are common with LBP?  What are the most important muscles during the golf swing?  Feel free to ask any questions you have.  Also check out our website under specialty programs to see our golf swing program, V1 golf swing analysis, and Titleist Performance Institute screen to get you to a pain free golf swing!

How Much is it Costing You Out of Pocket For Your Physical Therapy?

So we have reviewed why Pursuit Physical Therapy is cash-based, what evidenced based practice is and why it is important for you as a patient, and what is wrong with healthcare.  This post will show you the difference between a cash based practice vs and insurance based practice and how much it will cost you out of pocket.  Below is a table that shows the difference between a standard physical therapy practice and what it entails vs what Pursuit Physical Therapy offers.

Normal Standard Practice	Pursuit Physical Therapy Evidenced-Based Practice
3x  week for 4 weeks 12 sessions	2x a week for 2 weeks 4-6 sessions
No manual therapy	Manual Therapy
10+ exercises	4-6 exercises
60+ minute session	30-60 minutes session
Guided by health insurance	Guided by what the patient needs
Average out of pocket cost $500-1000	Average out of pocket cost $400-500
No incentive to get you better quicker	Incentive based

Many patients feel that they have insurance to cover their physical therapy and they do not want to pay out of pocket for physical therapy services.  So now we will review the difference in cost and an example of how much you pay out of pocket for each physical therapy service.  You think that since you have insurance that it will not cost you much out of pocket, but lets look at an example.   Now, every insurance policy is different, but we will use an example from what the average is that I have seen.  So we will factor in deductible, co-pay, and the miscellaneous bill that is sent to you house 3 months after you have received treatment.  Yes for some reason, with the standard insurance, sometimes they do not cover 100% of physical therapy services and I find more and more patients calling in 3 months after treatment saying that they received a bill from the hospital saying that they owe another couple hundred dollars for their treatment?? I know!

Normal Standard Practice Cost	Pursuit Physical Therapy Cost
3x a week for 4 weeks	4-6 treatment sessions
Average Deductable = $1000-5000	No deductible needed to be met
Co-pay = $20	No co-pay
Miscellaneous bill = $300	Each session =$75-100
12 visits x $20 = $240	6 visits x $100
+ 300
+ deductible ($500)
TOTAL = $1040	TOTAL = $600

So a cash based model turns out to be a cheaper out of pocket expense for the patient after all!  You also receive a much better quality of one-on-one care with a faster outcome.  Is it worth it to pay that much out of pocket at a standard insurance clinic, getting double booked with other patients and need to be seen for 3x a week for 4 weeks???  To me, I would rather pay less and get better faster.   What do you think about a cash based physical therapy service and how much you have to pay out of pocket?