Frequently Asked Questions (FAQs)

During your first visit you can expect the following:

• Arrive at your appointment with your paperwork completed (you can download it from our website).
• You will be seen for the initial evaluation by the therapist.
• The therapist will discuss the following:
• Your medical history.
• Your current problems/complaints.
• Pain intensity, what aggravates and eases the problem.
• How this is impacting your daily activities or your functional limitations.
• Your goals and upcoming events.
• Medications, tests, and procedures related to your health.
• The therapist will then perform the objective evaluation, which may include some of the following:
  1. Palpation - touching around the area of the pain/problem. This is done to check for the presence of tenderness, swelling, soft tissue integrity, tissue temperature, inflammation, etc.
  2. Range of Motion (ROM) - the therapist will move the joint(s) to check for the quality of movement and any restrictions.
  3. Muscle Testing - the therapist may check for strength and the quality of the muscle contraction. Pain and weakness may be noted. Often the muscle strength is graded. This is also part of a neurological screening.
  4. Neurological Screening - the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.
  5. Special Tests - the therapist may perform special tests to confirm/rule out the presence of additional problems.
  6. Posture Assessment - the positions of joints relative to ideal and each other may be assessed.
• The therapist will then formulate a list of problems you are having, and how to treat those problems. A plan is subsequently developed with the patient's input. This includes how many times you should see the therapist per week, how many weeks you will need therapy, home programs, patient education, short-term/long-term goals, and what is expected after discharge from therapy. This plan is created with input from you, your therapist, and your doctor.

You should wear loose fitting clothing so you can expose the area that we will be evaluating and treating. For example, if you have a knee problem, it is best to wear shorts. For a shoulder problem, a tank top is a good choice, and for low back problems, wear a loose fitting shirt and pants, again so we can perform a thorough examination.

We use towels in a very clever way to maintain your modesty, but please be prepared to expose the part of your body that needs treating, very few injuries are treated through clothing.

If you have any feelings of anxiety about this then please tell your therapist at the first meeting.

Treatment sessions typically last 30 to 45 minutes per visit. An orthotics fitting is 90 minutes and personal training 1hr.

This is highly variable. You may need one visit or you may need months of care. It depends on your diagnosis, the severity of your impairments, your past medical history, etc.

We offer 5 and 10 session deals for a reason, with 80% of clients opting for the 5-session deal offering approx. £5 off per treatment.

More than half of all the UKs population is suffering from pain. Whether it is a recent episode or chronic, a recent study revealed that pain in the UK is a serious problem. However, many do not even know that physiotherapists are well equipped to not only treat pain but also its source.

Physiotherapists are experts at treating movement and neuro-musculoskeletal disorders. Pain often accompanies a movement disorder, and physiotherapists can help correct the disorder and relieve the pain.

You have probably heard of the profession of physiotherapy. Maybe you have had a conversation with a friend about how physiotherapy helped get rid of his or her back pain, or you might know someone who needed physiotherapy after an injury. A physiotherapist might even have treated you yourself. But have you ever wondered about physiotherapists--who they are and what they do? Many people are familiar with physiotherapists' work helping patients with orthopedic problems, such as low back pain or knee surgeries, to reduce pain and regain function. Others may be aware of the treatment that therapists provide to assist patients recovering from a stroke (e.g., assisting them with recovering use of their limbs and walking again).

The ability to maintain an upright posture and to move your arms and legs to perform all sorts of tasks and activities is an important component of your health. Most of us can learn to live with the various medical conditions that we may develop, but only if we are able to continue at our jobs, take care of our families, and enjoy important occasions with family and friends. All of these activities require the ability to move without difficulty or pain.

Because physiotherapists are experts in movement and function, they do not confine their talents to treating people who are ill. A large part of our therapist's program is directed at preventing injury, loss of movement, and even surgery. Physiotherapists work as consultants in industrial settings to improve the design of the workplace and reduce the risk of workers overusing certain muscles or developing low back pain. They also provide services to athletes at all levels to screen for potential problems and institute preventive exercise programs. Physio&Therapy UK works with Olympic champions and world stage superstars.

With the boom in the golf and fitness industries, a number of therapists are engaged in consulting with recreational golfers and fitness clubs to develop workouts that are safe and effective, especially for people who already know that they have a problem with their joints or their backs.

The cornerstones of physiotherapy treatment are therapeutic exercise and functional training. In addition to "hands-on" care, physiotherapists also educate patients to take care of themselves and to perform certain exercises on their own. Depending on the particular needs of a patient, therapists may also "mobilize" a joint (that is, perform certain types of movements at the end of your range of motion) or massage a muscle to promote proper movement and function. Physiotherapists also use methods such as ultrasound (which uses high frequency waves to produce heat), hot packs, and ice. Although other kinds of practitioners will offer some of these treatments as "physiotherapy," it's important for you to know that therapy can only be provided by qualified therapists.

Most forms of physiotherapy treatment are covered by insurance however over 80% of our clients pay themselves.

http://www.apta.org/

You and others may be referred to physiotherapy because of a movement dysfunction associated with pain. Your difficulty with moving part(s) of your body (like bending at the low back or difficulty sleeping on your shoulder, etc.) very likely results in limitations with your daily activities (e.g., difficulty getting out of a chair, an inability to play sports, or trouble with walking, etc.). Physiotherapists treat these movement dysfunctions and their associated pains and restore your body's ability to move in a normal manner.

There is some significant research that shows the benefits of private clinics for the treatment of your injuries. Some just want to avoid the NHS delays and others want a fast and effective service.

Read on for more information.

• Mitchell, J., Scott, E., Physician Ownership of Physiotherapy Services: Effects on Charges, Utilization, Profits, and Service Characteristics, Journal of the American Medical Association, 1992.
• "Joint Ventures Among Health Care Providers in Florida," State of Florida Health Care Cost Containment Board, 1991.
• Domholdt E, Durchholz AG. Direct access use by experienced therapists in states with direct access. PhysTher. 1992 Aug;72(8):569-74.
• Federal Office of the Inspector General May 1, 2006 - This report calls into question billing processes done by non-physiotherapist owned practices.

In most cases the client pays us directly

There are those with private health insurance who will cover your treatment. Click on our insurance link above for a summary of insurances we accept and make sure you talk to our receptionist so we can help you clarify your insurance coverage.

You will be evaluated by one of our licensed and highly trained physiotherapists and he/she will either treat you during each visit or provide someone more suitable for your therapy. We feel it is very important to develop a one-on-one relationship with you to maintain continuity of care. Since one physiotherapist knows your problems best, he/she is the one that will be your case manager and work with you to speed your recovery.

Manual Therapy - Manual therapy is a broad term that describes a variety of hands-on treatment techniques that are applied to movement dysfunctions. Grade five mobilizations, Mulligan mobilizations with movement, Maitland and Kaltenborn techniques, functional technique, neural mobilization, joint mobilization, craniosacral therapy, strain/counter strain, myofascial release, etc. These are some of the more popular manual therapy techniques. Most physiotherapists incorporate manual therapy techniques as a part of a complete treatment plan.

Sports Rehabilitation - Experts in assisting with recovery after injury and surgery. Many sports specialists help with retraining the athlete utilizing running, throwing, jumping, and sport-specific programs. GAIT re training and running coaching is available and provides a great platform for those concerned about how best to train or feel they experience pain when exercising.

Fitness and Wellness - Physiotherapists are well trained to help with your fitness needs and wellness programs. At Physio&Therapy most of our practioners have represented their country at their chosen sport, many have sports science degrees and or sports therapy degrees, there are rarely auch highly qualifies practioners on offer

If you need an exercise program, have trouble with your weight, are concerned about your training, our physiotherapists can help. 362 clients ran the london marathon last year, many of these followed our training schedules.

For many patients, one of the primary objectives is pain relief. This is frequently accomplished with hands-on techniques, modalities such as ultrasound, electrical stimulation, and/or heat or cold therapy. Movement often provides pain relief as well. Your physiotherapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance.

In some cases, physiotherapy techniques can be painful. For example, deep tissue massage or recovering shoulder range of motion after shoulder surgery may be painful. Your physiotherapist will utilize a variety of techniques to help maximize your treatment goals. It is important that you communicate the intensity, frequency, and duration of pain to your therapist. Without this information, it is difficult for the therapist to adjust your treatment plan.

There are dozens of different types of treatment interventions. Here is a list of treatment interventions:

Active Range of Motion (AROM) - the patient lifts or moves a body part through range of motion against gravity. AROM is usually one of the first modalities prescribed for arthritis.

Active Assistive Range of Motion (AAROM) - therapist-assisted active range of motion. This is usually prescribed for gentle stretching or strengthening for a very weak body part.

Gait or Walking Training - the analysis of walking & running problems by visually examining the interaction of the low back and the joints of the thighs, legs, and feet during the various stages of walking & running including initial contact, loading response, mid stance, terminal stance, pre swing, mid swing, and terminal swing. Many back, thigh, leg, ankle, and foot problems may be caused by or manifest themselves in subtle gait abnormalities.

We have the Dartfish video gait analysis to make this process more scientific and user friendly. An extremely beneficial service we can provide is to compare before and after intervention on screen.

Isometrics - muscle contraction without joint movement. This is usually prescribed for strengthening without stressing or damaging the joint (e.g., arthritis, or exercises to be performed in a cast, or right after surgery if recommended by the therapist/doctor).

Isotonics- muscle(s) contracting through the ROM with resistance. This is usually prescribed for strengthening.

Soft Tissue Mobilization - therapeutic massage of body tissue performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesions, and for pain relief.

Mobilization - hands-on therapeutic procedures intended to increase soft tissue or joint mobility. Mobilization is usually prescribed to increase mobility, delaying progressive stiffness, and to relieve pain. There are many types of mobilization techniques including Maitland, Kaltenborn, Isometric Mobilizations, etc.

Proprioceptive Neuromuscular Facilitation (PNF) - a system of manually resisted exercises performed in diagonal patterns that mimic functional movements. PNF was initially used in developmentally and neurologically impaired patients but now is used in almost every aspect of neuromuscular retraining from athletes in sports facilities to the very weak in hospitals and nursing homes.

Posture Training - instruction in the correct biomechanical alignment of the body to reduce undue strain on muscles, joints, ligaments, discs, and other soft tissues. There is an ideal posture, but most people do not have ideal posture. Therapists educate patients about the importance of improving posture with daily activities. Stretching and strengthening exercises may be prescribed to facilitate postural improvement and to prevent further disability and future recurrences of problems.

Progressive Resistive Exercises (PRE) - exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

Passive Range of Motion (PROM) - the patient or therapist moves the body part through a range of motion without the use of the muscles that "actively" move the joint(s).

Stretching/Flexibility Exercise - exercise designed to lengthen muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain,spasm or immobilization.

Cryotherapy or Cold Therapy - used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain.

Neck Traction - a gentle longitudinal/axial pull on the neck, either manual or mechanical, intermittent or continuous for relief of neck pain, to decrease muscle spasm and facilitate unloading of the spine.

Heat - heat is recommended to decrease chronic pain, relax muscles, and for pain relief. It should not be used with an acute or "new" injury.

Pelvic Traction - the longitudinal/axial pull on the lumbar spine, either manual or mechanical, intermittent or continuous. Pelvic traction may be helpful for the relief of low back pain and muscle spasm.

Ultrasound - ultrasound uses a high frequency sound wave emitted from the sound head when electricity is passed through a quartz crystal. The sound waves cause the vibration of water molecules deep within tissue causing a heating effect. When the sound waves are pulsed, they cause a vibration of the tissue rather than heating. The stream of sound waves helps with nutrition exchange at the cellular level and healing. Studies have shown that ultrasound is helpful for ligament healing and clinically, for carpal tunnel syndrome, and muscle spasm.

Massage may be part of your treatment. Rehabilitation specialists are trained in a variety of techniques that may help with your recovery. Deep tissue techniques may be part of the rehabilitative process. Massage is used for three reasons typically - to facilitate venous return from a swollen area, to relax a tight muscle, or to relieve pain. Contrary to common thought, massage does not increase circulation.

Flare ups are not uncommon. If you have a flare up (exacerbation), give us a call. We may suggest you come back to see us, return to your doctor, or simply modify your daily activities or exercise routine.

In most cases, you have the right to choose any physiotherapy clinic. Our practice is a provider for many different insurance plans.