Physical therapy is the application of principles and techniques aimed at restoring motion, increasing strength and maximizing function of a body part or system when these are lost due to injury, illness or disease. The goals of physical therapy interventions often include: increasing a range of motion, increasing strength, decreasing pain and re-establishing or integrating a lost movement function. Sometimes, however, the goals also include interventions aimed at stabilizing excessive joint movements or instabilities. These might result from injuries leading to ligamentous laxity, genetic pre-disposition, or in the case of the spine, age related changes.
Physical therapists are experts in movement science who have specialized knowledge about the complexities of human movement from the perspectives of anatomy, physiology, neurosciences, physics, and exercise physiology. Experienced physical therapists have an intimate understanding of both normal and pathological movement. They have the ability to critically analyze movement dysfunction and determine what interventions will be most useful for your condition.
Physical therapists are people who work hard for their patient's well-being. They share your desire to feel and move well. They are both empathetic and objective about your physical condition. Their efforts to help you should be readily visible whether you are an injured worker who performs heavy work or are a finely tuned athlete whose body is his/her livelihood. A physical therapist's work intertwines with many types of people from many walks of life and it can be a rewarding experience to enhance the quality of life of others.
Physical therapists acquire their education through both extensive university academics and clinical training. They obtain entry into professional degree programs after completing general education and undergraduate degrees in related fields such as exercise physiology, health science, kinesiology, or anatomy. The pre-requisite coursework for physical therapy school includes: anatomy, physiology, biology, physics, chemistry, psychology, neuroanatomy, normal and abnormal psychology, child development, and health statistics. Physical therapy programs today are producing graduates with both entry-level master's degrees and those with clinical doctorates. Programs emphasize clinical medical sciences along with the theory and practice of physical therapy. One must complete an accredited program in order to sit for the national licensure exam and in order to receive the professional designation of physical therapist.
As licensed professionals, physical therapists are respected members of the allied health care community. They work in concert with other members of the health care community such as physicians, surgeons, podiatrists, dentists, rehabilitation nurses, occupational therapists, speech pathologists, social workers and psychologists.
Physical therapists work in a variety of settings and treat a variety of patients. Many physical therapists are found in hospital settings but today the majority is distributed throughout private practices, nursing homes, health clubs, sports teams/facilities, research institutions, schools, pediatric treatment centers, and universities. The location in which a physical therapist works is the result of many factors including personal factors, professional interests and types of skills. Some pursue environments where there are opportunities to practice in specialty areas such as: orthopedics, neurological, pediatric orthopedic or neurological, cardiopulmonary, sports, electrodiagnostics or research.
To be sure, there are many arrangements under which physical therapists work. Some are employees of institutions or private practices while others are working on some type of contractual basis. Still others are owners and operators simultaneously carrying out the majority of patient care and the business administrative aspects of their practices. The type of arrangement depends on each clinician's unique talents, interests and personal situation.
People are referred to physical therapy for a variety of reasons. Often the referral is triggered by a patient's complaint of pain. Usually, the complaint is accompanied by some loss of mobility or functional decline. This could be the result of a frank injury as when an athlete twists an ankle or takes a damaging blow to a knee. Sometimes the onset of the pain or problem is insidious; it just comes on gradually or progresses to a point slowly over time that it can no longer be ignored. Sometimes the referral is to begin the recovery from a surgical process that necessarily results in some pain and swelling. Whether your particular pain or problem is very new or chronic in nature, your physician recognizes that physical therapists are experts in movement science and have the unique knowledge necessary to evaluate you and determine how the tools they possess can help your inflamed or injured tissue heal.
On your first visit you should expect an evaluation of your present physical condition beginning with a thorough history, initial observations of your overall movement and posture, detailed measurements of your range of motion, strength, and functional impairments including the way you walk or run (gait), or jump, or sometimes throw. Also, passive assessments of joint play or accessory mobility should be made and finally special testing intended to selectively stress tissues for their stability or aid in differentiating types of tissues involved in pain generation should be performed.
On subsequent visits, the therapist should have a “game plan” formulated from the data collected at the initial exam. He or she will employ hands on techniques (manual therapy), and unique therapeutic exercise to stretch, strengthen or re-educate muscles. Also, you will be educated on how to best care for your condition when you are not at your sessions. These interventions will be aimed at mutually determined goals for your progress and functional improvement.
After a thorough initial evaluation the physical therapist should be able to give you a fair approximation of how frequent and for what duration you will need to be seen in order to achieve the stated goals. At the minimum he/she should be able to tell you when you could expect some improvement in your condition. Of course, your mutual participation in carrying out treatment is a huge factor in the success of your treatment and will impact both the frequency and duration of your care. Patients are often seen 2 to 3 times weekly for 4-6 weeks and then a formal re-evaluation of progress is conducted. Sometimes patients require a larger bolus of treatment in the initial weeks where education and manual therapy is more intense. Often, frequency can subsequently be reduced commensurate with improvement or the need to rehabilitate tissues more slowly over a longer period. Some post-surgical care such as knee ligament reconstruction, rotator cuff repair and joint replacement have become increasingly more standardized making outcomes and rehabilitation guidelines more easy to predict. These situations should be discussed with your therapist.
Only a licensed physical therapist will administer your care. We do not utilize aides or physical therapy assistants. All of your care will be administered by the same individual who initially evaluated you. The only exceptions to this occur when alternative coverage is provided during a therapist's personal time off, or when you are co-treated to accommodate your schedule or best address your physical needs. Presently, all of our permanent clinicians have fourteen or more years in the field. Collectively this staff has 70 years of experience in the field of physical therapy (link to staff biographies
Your session will range from one-half to one and one-half hours in length. We always strive to use your time wisely and maximize your health care dollar.
This is a tricky question. The correct answer is no. In Virginia, you may consult with a Physical Therapist for evaluation and treatment. Treatment may not exceed 14 consecutive business days. You are required by state law to complete an attestation which indicates: 1) you are not currently under the care of another health care practitioner; 2) the name of a health care practitioner (M.D.) with whom you intend to seek treatment if the condition doesn't improve during physical therapy; 3) you agree to release personal health information to the health care practitioner of record. The physical Therapist is required to provide the written initial evaluation and plan of care to the health care practitioner identified with in 3 days of treatment. Direct assess may not be utilized if you were seen previously via direct access within the previous 90 days.
On your first appointment you should arrive a few minutes early, with your initial paper work completed, allowing time for our receptionist to acquire any insurance information from you and assemble your chart. All new patients have initial standard paper work to fill out and depending on the area being treated certain forms which are unique to their condition. You will be instructed which forms are necessary to complete when scheduling (link to forms
). If you elect to complete your paper work at our office, please arrive 20 minutes early in order to have ample time to finish the forms prior to your appointment. In addition to your insurance information you should also bring your prescription from the doctor and any pertinent radiology and post-operative reports you may have in your possession. Also, if you have radiographs or MRI studies bringing them will allow the therapist a more complete understanding of the severity of your condition. He or she will examine them for structural concerns, and joint health and this could be useful in determining how your anatomy will be impacted by certain types of exercise and manual therapies.
In terms of attire, you should wear or bring clothing which allows the involved body region to be exposed during examination and treatment. For patients with back problems that means shorts with elastic waist and a loose fitting t-shirt. For females with upper back, neck or shoulder problems you will need to wear a top with narrow t-straps and open shoulders or the equivalent of a sports bra. For your convenience we do provide halter tops, hospital gowns, shorts and t-shirts at the clinic if you prefer to use these.
You can help yourself the most by actively participating in your treatment plan. A substantial part of our treatment will involve educating you in techniques, drills, activities and exercise which are specific to your needs. To remodel connective tissue and strengthen muscle requires you to execute your program. Without your conscious effort to involve yourself in treatment and take ownership of the problems needing to be addressed, your chances of lasting success and improvement are more limited.
Finally, certain conditions are prone to “flare-ups”. These often happen when activity isn't paced properly so that the intensity of forces/stresses becomes too great for healing or weakened tissues. We will advise you on how to stage your exercise to coincide with expected healing time frames for your particular type of problem. We will teach you ways to distinguish appropriate soreness and discomfort from potentially unhealthy types of discomfort or pain and give you healthy guidelines to self-assess how much you can challenge yourself. Your participation and attention to these will help you dodge self-destructive behaviors, and avoid the fear-anxiety cycle which so often accompanies painful movement.
Your initial examination will sometimes involve more movement in various ways than you have done in some time. As a result, you may be sore. How severe and how long lasting this is will be factored into your subsequent treatment. We have a vested interest in reducing and resolving your pain. To turn an old weight-room adage upside down, we will pursue “gain without pain”. You should expect discomfort at times and understand that not all pain is indicative of harm. We are sensitive to the fact that people respond differently to potentially painful stimuli and that those responses may vary depending on a host of factors. We will always respect any pain you have and try to help you find ways to find relief from the pain symptom.
Some conditions unfortunately, require us to cause some mild pain in order to get some ultimate relief of pain and restoration of motion. In these cases we will communicate closely with you to ensure your treatment is not too uncomfortable and that your body's subsequent reactions are appropriate.