What happens during my first visit?

One should expect the follow on a first visit:

Arrive at your appointment with your paperwork completed (see forms section)

Provide us with your prescription for therapy and insurance card for copying.

You will meet your therapist and receive a comprehensive initial evaluation, during which the therapist will discuss the following: Your current problems/complaints, pain intensity (what aggravates/eases the problem) and how it impacts your daily activities, your functional limitations, and your short term and long term goals for physical therapy. In addition, your therapist will discuss your medical history, medications, tests, and procedures related to your injury. The therapist will then perform the objective evaluation which may include: Range of Motion measurements, Palpation, Muscle Testing, Neurological Screening, as well as others.

Your therapist will analyze your injury and, along with patient and physician input, formulate a treatment plan. This plan will outline how many times you should be seen for physical therapy per week, how many weeks you will likely require therapy, short-term/long-term goals, and what is expected after discharge from therapy. Home programs and patient education will also be addressed.

Ergo-Rehab has treated over 6,000 patients over the past 5 years. Below is a breakdown of some of the more common injuries we have treated and the frequency of treatment during a typical year:

• Back Pain
• Knee Injuries
• Shoulder Injuries
• Neck Pain
• Stress Fractures
• Hand injuries
• Carpal Tunnel Syndrome
• Tennis Elbow
• Tendinitis Arthritis
• Stress Fractures
• Auto Injuries and Whiplash
• Scoliosis
• Plantar Fasciitis
• Tingling/Numbness
• Rotator Cuff injuries
• Sprains
• Muscle Strains

Treatment sessions typically last from 45 to 75 minutes.

Depending on your diagnosis, the severity of your impairments, your past medical history, and other factors you may need one visit or several weeks of care. Should your care last three to four weeks, you will be re-evaluated by your therapist and a progress report will be sent to your physician with recommendations.

Physical therapists are experts in movement and function. The cornerstones of physical therapy treatment are therapeutic exercise and functional training. In addition to "hands-on" care, physical therapists also educate patients to take care of themselves and to perform certain exercises on their own. Depending on the particular needs of a patient, physical therapists may also "mobilize" a joint (that is, perform certain types of movements at the end of your range of motion) or soft tissue mobilization to promote proper movement and function. Physical therapists also use modalities such as ultrasound, hot packs, electrical stimulation and ice.

You and others may be referred to physical therapy because of a movement dysfunction associated with pain. Your difficulty with moving part(s) of your body may result in limitations with your daily activities. Physical therapists treat these movement dysfunctions and their associated discomforts and restore your body's ability to move in a normal manner.

Physical therapy addresses functional impairment as related to pathology. In other words, if there is something wrong with your body (trauma or strain or stroke….etc.) you will have certain functional limitations which can be assessed and treated by a physical therapist.

Chiropractors are doctors whose primary focus is on the functioning of the spinal column, and therefore diagnose and treat mainly spinal subluxations (partial dislocation, as of one of the bones in a joint). Straight chiropractors believe that subluxations are the leading cause of all disease in the body, and that these diseases won't be a problem if you have the correct spinal manipulations.

The American Physical Therapy Association states that a physical therapist should be:

• Examining individuals with impairment, functional limitation, and disability or other health related conditions in order to determine a diagnosis, prognosis, and intervention.
• Alleviating impairment and functional limitation by designing, implementing, and modifying therapeutic interventions.
• Preventing injury, impairment, functional limitation, and disability, including the promotion and maintenance of fitness, health, and quality of life in people of all ages.
• Engaging in consultation, education, and research.

The American Chiropractic Association defines chiropractic therapy as:

• A drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling. The most common therapeutic procedure performed by doctors of chiropractic is known as “spinal manipulation,” also called “chiropractic adjustment.”

Who is better to see, a PT that works for a physician or a PT that owns a private practice? We’ll leave it up to you to decide but here are some facts: Studies indicate there were more treatments (visits per patient were 39% to 45% higher in physician owned clinics) and the cost was greater for those patients that attended a physician owned physical therapy practice (both gross and net revenue per patient were 30% to 40% higher)

Mitchell, J., Scott, E., Physician Ownership of Physical Therapy Services: Effects on Charges, Utilization, Profits, and Service Characteristics, Journal of the American Medical Association, 1992.

Ultimately, this is your choice, you are free to ask your doctor, look over our profiles or briefly talk to a therapist before you commence your therapy. However, you should know and expect that at Ergo-Rehab you will be evaluated by a licensed and highly trained physical therapist. At Ergo-Rehab, the same therapist will treat you each time as we feel it is very important to develop a one-on-one relationship with you to maintain continuity of care. Since only one physical therapist knows your problems best, he/she is the one that will be working closely with you to speed your recovery.

Orthopedic Physical Therapy - Probably the most common physical therapy specialty is orthopedic. These specialists care for post-surgical patients, arthritis, tendinitis, fracture rehabilitation, muscle sprains and strains, neck and back pain, hip and knee problems, shoulder, elbow, and wrist conditions.

Manual Therapy - Manual therapy is a broad term that describes a variety of hands-on treatment techniques that are applied to movement dysfunctions. Some of the more popular techniques include: Mulligan mobilizations with movement, Maitland and Kaltenborn techniques, functional techniques, neural mobilization, joint mobilization, craniosacral therapy, strain/counter strain, and myofascial release. Physical therapists at Ergo-Rehab incorporate manual therapy techniques as a part of a complete treatment plan.

Sports Rehabilitation – This specialty focuses on assisting with recovery after injury and surgery. Many sports specialists help with retraining the athlete utilizing running, throwing, jumping, and sport-specific programs.

Aquatic Physical Therapy - Aquatic therapy takes advantage of the physical properties of water to assist with the rehabilitative process. Buoyancy, turbulence, hydrostatic pressure, and thermal properties of water can assist with the rehabilitation of a patient. Those suffering from chronic pain, osteoarthritis, fibromyalgia, rheumatoid arthritis, lumbar surgery, or with a limited weight-bearing status are just a few of the many different patient populations that can benefit from aquatic therapy. Our location at 2675 Stevenson specializes in aquatic therapy.

Hand Therapy – Some physical therapists and Occupational therapists are well trained to treat hand and wrist conditions. Even fewer therapists have taken additional courses and training and have passed a hand therapy certification examination. These therapists are called Certified Hand Therapists (CHTs). Ergo Rehab has a CHT on staff at its State Street location.

Wound Care - Some therapists specialize in the treatment and care of wounds. This is accomplished by the removal of unviable tissue (debridement), the application of special dressings and prescription drugs/ointments, and the use of ultrasound, electrical stimulation, and aquatic modalities to promote healing. Our hand therapists specialize in wound care.

Industrial Rehabilitation - Specialists in industrial rehabilitation help with those that have suffered on-the-job injuries. They evaluate work tasks, fabricate assistive devices, evaluate your ergonomic situation, and help redesign work tasks to decrease the incidence of injury. Often, industrial rehabilitation specialists will evaluate your ability to perform certain job tasks with a Functional Capacity Evaluation (FCE).

Billing for physical therapy services is similar to what happens at your doctor's office. When you are seen for treatment, the following occurs:

• The physical therapist bills your insurance company using Common Procedure Terminology (CPT) codes. Those codes are transferred to a billing form that electronically communicated (or in the case of Workers comp, mailed) to the payer.
• The payer processes this information and makes payments according to an agreed upon fee schedule.
• An Explanation of Benefits (EOB) is generated by your insurance company and sent to the patient and the physical therapy clinic with a check for payment and a balance due by the patient.
• The patient is expected to make the payment on the balance, if any.

It is important to understand that there are often many small steps beyond those above within the process and exceptions are common. At any time during the billing process, information may be missing, miscommunicated, or misunderstood. This can delay the payment process. While it is common for the payment process to be completed in 60 days or less, it is not uncommon for the physical therapy clinic to receive payment as long as six months after the treatment date.

Some patients will need to continue with home exercises. Some may choose to continue with a gym exercise program while others will complete their rehabilitation and return to normal daily activities immediately. It is important that you communicate your goals to your therapist, so he/she can develop a custom program for you.

Some of the things you may consider when seeking a physical therapy clinic:

• Is the Clinic licensed by Medicare?
• The first visit should include a thorough medical history and physical examination before any treatment is rendered.
• The patient goals should be discussed in detail during the first visit.
• What are the hours of operation?
• Can they provide satisfaction survey results?
• Can you briefly interview the therapist before the first visit?
• Does the clinic employ licensed therapists?
• Is the clinic members in physical therapy provider networks which perform quality assurance programs and accreditation visits (Preferred Therapy Providers (www.preferredtherapy.com) and Physical Therapy Provider Network (www.ptpn.com) are two selective independent physical therapy provider networks in CA with quality assurance programs)?
• Do they provide services that can address your problem?
• Do they take your insurance or are they willing to work with you if they are not a preferred provider?

Hours depend on the therapist and clinic, but generally we can accommodate patients from 7AM to 6PM, Monday through Friday. If your schedule is limited by day or time, please let our receptionist know before your initial visit as it may influence which Therapist you are assigned to.

In 1999, we outgrew the one clinic on Stevenson Blvd. At that time, we decided to maintain a stand alone clinic at that location which specializes in aquatic and sports physical therapy. Our location on State Street, operates with three of our Physical Therapists and houses our Hand Therapy Department and billing/management office.

Ergo-Rehab has been a member been an independent, therapist owned physical therapy clinic since 1979.

In most cases, health insurance will cover your treatment. We accept all PPOs, all workers compensation insurance, Medicare, and a limited number of HMOs. We also have plans for cash patients. Please call our office for specific coverage information.